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Knee Pain

Exercises for Patellar Tendonitis

Minute Read

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2 months ago

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by james

Patellar tendonitis is a painful condition of the knee. This injury develops when the tendon that attaches the quadriceps muscle to the shin bone becomes overloaded and painful, and fails to repair itself. This state of disrepair is called tendonitis or tendinopathy. Because this injury occurs commonly in basketball and other jumping sports, it is also known as Jumper’s Knee.

The Benefits of Strengthening Exercises for Patella Tendonitis

To recover from this injury the cause must be identified, address and the tendon will then need time to settle from the aggravation and will need the correct stimulation to repair. A physical therapist can help with this. The injury may be due to several different causes such as biomechanics, an error in training, or trauma. Once the cause has been identified it can be addressed. If biomechanics were the issue, then it is best to be assessed by a physical therapist and they will provide you with some rehabilitation exercises to correct this. For a training error, it is often a sudden change or an increase of volume or intensity that was beyond what the body could absorb. We can learn from these mistakes to know what our body can cope with, and a coach or trainer can help make a better plan to avoid these injuries developing in the future.

While the causes are being addressed the tendon can be rested, or given “relative rest”. That is a significant reduction of the aggravating activity, such as being able to continue running but with less volume, only on the flat, and with no speed work, for example. But even with rest, the tendon will not recover. It needs stimulation to change from a tendinopathic state to a healthy state. This stimulation comes in the form of loading the tendon with strengthening exercises.

Rehab Protocols for Patella Tendonitis

There are two main groups of exercise protocols that have been studied and shown to work well to heal the tendon: eccentric exercises and heavy slow resistance training. For patella tendonitis, heavy slow resistance training has been shown to be more effective (Kongsgaard et al 2009). However, it is not always possible to do depending on the person and what they might or might not have access to in terms of equipment. Therefore, both are discussed here.

Eccentric Exercises for Patellar Tendonitis

A single leg eccentric squat on a 25º decline or slant board. The lowering phase should be done on the affected leg and the unaffected leg should be used to return to standing. If both legs are affected the exercise must be done separately for each leg and to return to standing both legs and their arms. The single-leg exercise performed on a 25º slant board has shown to be more effective than the same exercise done on flat ground, for reducing pain and returning to sport (Purdam et al 2006).

Frequency: 2x daily

Tempo: 3 seconds in each direction

Rest time: 2 minutes

Sets: 3x

Repetitions: 15x

Photo of woman doing decline squat for patellar tendonitis

Heavy Slow Resistance Training for Patellar Tendonitis

Four sets of these three exercises should be done three times per week with 2-3 minutes rest between sets. The movement of the knee should take 3 seconds from 0º (straight) to 90º bend and 3 seconds to return to 0º. Pain should be acceptable and should not increase after finishing the training session. During the 12 weeks of tendon rehab training, it is allowed to continue with light sport provided that pain during the exercise is light (advised maximum of 3/10 pain).

Frequency: 3x weekly

Tempo: 3 seconds in each direction

Rest time: 2-3 minutes

Sets: 4x

Repetitions and weight changes over the program as follows:

  • Week 1 = 15RM (repetition maximum)
  • Week 2-3 = 12RM
  • Week 4-5 = 10RM
  • Week 6-8 = 8RM
  • Week 9-12 = 6RM

Leg Press

Photo of woman doing leg press for patella tendonitis

Back Squat

Hack Squat

Photo of man doing hack squat for patellar tendonitis

Additional Exercises for Patellar Tendonitis

Other exercises can be helpful for the recovery of patellar tendonitis, as well as to prevent it from occurring again in the future. These should focus on flexibility issues or strength deficits that might exist. Stretching and foam rolling to reduce tension in tight muscles as well as targetted strengthening for weak muscles such as the posterior chain which includes the calf, hamstrings, and gluteal muscles. You can read more about other treatments in another article “How do you treat patellar tendonitis“.

Physiotherapy with James McCormack

This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.

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