Patella tendinopathy - progressive tendon-loading exercise therapy


Patella tendinopathy affects as many as 45% of elite athletes who take part in jumping sports, such as basketball and volleyball. Pain is often reported below the knee cap, and on load-bearing exercises.


Tendinopathy refers to chronic tendon injury, where there is minimal inflammation, so anti-inflammatory treatments are therefore discouraged.


Eccentric exercise therapy (EET) is strongly recommended by the National Institute for Health and Care Excellence (NICE). However, EET is pain-provoking and the therapeutic effects on pain and functional outcome are debated. An alternative consists of progressive tendon-loading exercises (PTLE) within the limits of acceptable pain. A research study was conducted to compare their effectiveness in athletes with patella tendinopathy.


PTLE consisted of isometric, isotonic and explosive exercises within limitations of pain. Eccentric exercises were pain provoking using a single leg decline squat.


Results indicated that PTLE resulted in a higher return to sport when compared to EET (43% Vs 27%). Subjects also reported less pain in a 24 week follow up. Given this new approach, PTLE should be regarded as standard initial care for the treatment of patients with patella tendinopathy.