Patellar Tendon Rehab Phase 1
Patellar tendon pain and knee pain at the front of the knee is one of the most common complaints I see in the clinic. Due to the high volume of squats, box jumps, and other plyometric movements there is a ton of volume and force going through the knee. Unfortunately so many people take complete rest from the gym then they begin to feel better and they come back only to be injured again in a few weeks. They run this viscous cycle of injury---> complete rest --> back to the gym ---> reinjury and then they finally get help. At this point their pain is so severe and they are frustrated because they have been dealing with it for months.
The patellar tendon runs from the knee cap down to the tibial tuberosity where is inserts. With every quadriceps contraction the patellar tendon gets pulled on. There is increased demands on the patellar tendon in athletes who are regularly squatting and jumping like in CrossFit. The greatest amount of force on the patellar tendon occurs at the bottom of the squat and with plyometric movements such as box jumps, running, double under etc.
We can utilize these principles in rehabbing athletes and getting them moving immediately.
The worst thing to do for an injury is complete rest. Relative rest is the answer. We need time to let the tissues heal but we have to provide adequate load to the healing tissues. Tendons heal by being pulled on you just have to be smart about it. If you’re having patellar tendon pain here is my go to exercises early to load those tissues up and get on on the road to recovery.
Heavy Isometrics is the name of the game for healing tissues. It is sub maximal to a full contraction or full squat and has the ability to relieve pain. It releases pain reducing chemicals into the surrounding tissues, so it helps you feel better, get stronger, and heal up faster.
General rule of thumb with isometrics- Your pain should be 4/10 or less on a pain scale. 0 is no pain and 10 is a trip to the emergency department . This has be validated in research as a safe and effective threshold to approach to improve tendon strength without increasing pain. Keep that in mind with these exercises.
Self Knee Extension Isometric
This is a great exercise because it can be done anywhere and without any equipment. When I had a bout of patellar tendonitis I did this exercise 6-10 times throughout the day. Remember to keep it below the 4/10 threshold we talked about earlier.
Wall Sits with Kettlebell
Again we are utilizing the principle that isometrics provide pain relief and submaximal loading to the tendon to allow for immediate strengthening of the injured tissue. Take care and air on the side of less initially. Again this should be 4/10 or less on the pain scale and when you let off the repetition you should not have increased pain after. This can be scaled by reducing the weight, the time of the hold, and the depth of the squat. This one should only be performed twice per day initially.
Next week we will dive into later stages of rehab as we utilize our advanced forms of tendon loading like eccentrics and plyometrics.
If you are dealing with pain, tired of missing workouts and your stuck in the pain cycle, and need a trusted medical professional to help get you the answer you are looking for, complete the contact form on our page. This will allow me to reach out to you so that we can have a free phone consultation about what's going on so that we can help you get answers and get you healthy as quickly as possible.