Patella tendinopathy affects as many as 45% of elite athletes who are involved in jumping sports like basketball and volleyball. Due to the chronicity of the injury, it can have detrimental effects on athletic performance and health.
Patella tendinopathy is mostly non-inflammatory, with structural degenerative changes occurring in the tendon tissue. Therefore, anti-inflammatory approaches to treatment are often discouraged as their effects are unproductive.
Conservative intervention has historically employed eccentric exercise therapy (EET), where the tendon is lengthened under load. However, this inherently is pain provoking despite being an effective tool for recovery. More recently, progressive tendon loading exercises (PTLE), broken into four stages, consists of isometric, isotonic, plyometric and sports-specific movements, which are performed with minimal pain.
From the largest research study conducted involving individuals with patella tendinopathy, two groups either underwent a 24-week eccentric exercise programme, or a 24-week progressive tendon loading exercise programme. Results elicited a clinically significant benefit to those who underwent PTLE when compared to the EET group. There was also a higher return to sport rate in the PTLE group (43% vs 27%), as well as a significantly lower level of pain reported whilst performing the exercises.
Breda, S.J. et al. (2021). Effectiveness of progressive tendon loading exercise therapy in patients with patella tendinopathy: a randomised clinical trial. British Journal of Sports Medicine. 55: 501-509.