Exercise6 min read
Patellar tendinopathy exercise: a stage-by-stage programme
A patellar tendinopathy programme advances in four stages, each with clear criteria for progression. Skipping a stage is the most common error and the one that most prolongs the process.
Stages one and two
Stage one is isometric: the quadriceps contracts with the knee held at around sixty degrees. Forty-five-second holds, five repetitions, once or twice a day.
The aim of this stage is reducing pain and activating the muscle. Building strength is not its goal.
Stage two moves to slow-tempo double-leg work, progressing from wall sits to controlled squats at three seconds down, three seconds up.
Stage three: heavy loading
Work moves to single-leg exercises with added weight. Bulgarian split squats and decline single-leg squats are the core movements of this stage.
Load should be challenging at six to eight repetitions. That provides the stimulus tendon adaptation needs; light sets of twenty do not.
It is done three times a week. Enough recovery is left between sessions; heavy loading every day disrupts adaptation.
Stage four: speed and jumping
Jumping and landing work is added: double-leg first, then single-leg; in place first, then forward and lateral.
Landing quality is checked. The knee drifting inward and a noisy landing indicate load on the tendon is uncontrolled.
The return-to-sport criterion is performance, not time: strength at least ninety per cent of the other side, pain-free single-leg hop and pain-free landing control.
Key points
- The programme has four stages; skipping one prolongs the process.
- The isometric stage aims at pain reduction and activation, not strength.
- Heavy loading should be challenging at six to eight repetitions.
- Heavy loading every day disrupts tendon adaptation.
- The return-to-sport criterion is performance, not time.
Frequently asked questions
Why is a decline board used?
Squatting on a decline directs most of the load to the patellar tendon. It is the most practical way to load the tendon specifically.
Should I continue if I feel pain?
Continue where pain does not exceed three out of ten and returns to normal the next morning. Working pain-free is not required here; the criterion is the threshold.
How long until I gain strength?
Measurable strength gains appear in six to eight weeks. Adaptation in tendon structure is slower, and full recovery can take twelve weeks to six months.
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This content is for information only and does not replace medical diagnosis or treatment. Response to treatment varies between individuals. Please consult a healthcare professional about your symptoms.