Mend Physical Therapy Blog and Injury Information

What Is The Best Form Of Exercise For Patients With Patellar Tendinopathy

November 21, 2023

Patellar tendinopathy is a painful condition along the tendon below the knee cap commonly diagnosed in jumping or bounding athletes.  In our Boulder Physical Therapy and Lafayette Physical Therapy clinics we often encounter this diagnosis among patients who did too much too soon or too little for too long.  Tendons require consistent loading through exercise with adequate rest in order to have optimal health.  Injured tendons also require exercise in order to remodel or repair and mature the injured tissue.

Much of the eccentric exercise discussion originated with Alfredson and colleagues initial article in the 90s on achilles tendinopathy.  Since then many research articles have shown eccentric exercise is not superior to general loading protocols focused on concentric and eccentric movements, power, and sport specific training.  Researchers recently asked which was superior in patellar tendinopathy.

Breda and colleagues published their findings on exercise type in patients with patellar tendinopathy in the British Journal of Sports Medicine (2021).  Authors randomized 76 people with patellar tendinopathy to either eccentric exercise or progressive strength training.  They found progressive loading was superior to eccentric training among this group of participants with greater improvements in pain and disability.  In addition, greater return to sports was found in the progressive loading group.

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