Progressive Exercises for Patellar Tendinopathy
Updated: 5 days ago
Patella tendinopathy, often called jumper’s knee, is a common cause of pain at the front of the knee around the bottom part of your patella tendon, and aggravated by exercise (Malliaras et al., 2015).
It frequently affects athletes who participate in sports involving jumping, sprinting and rapid changes of direction, such as basketball, volleyball and football.
The good news? Progressive exercises for patellar tendinopathy are the gold-standard approach for reducing pain and building your tendons' tolerance over time.
At Tide Physiotherapy & Health, we use a progressive, three-phase approach to rehabilitation. Here are some of the most effective exercises for patella tendinopathy and how to incorporate them into your recovery.
Exercises For Patellar Tendinopathy Phase 1: Isometric Exercises
The first phase focuses on isometric exercises, where your muscles generate force without the knee joint moving significantly. These exercises provide an accessible starting point for loading the tendon while managing symptoms, and has been shown to be effective at reducing pain (Rio et al., 2015).
Exercises to try include:
Wall sits: Lean against a wall with your knees bent and hold the position.
Lunge isometrics: Lower into a lunge and hold a comfortable position.
Leg extension isometrics: Push against resistance while keeping your knee at a fixed angle.
Start with 5 sets of 30-second holds, three times per week. Over the following two to three weeks, aim to increase your frequency to four or five sessions per week if your symptoms tolerate it.
My rule of thumb is keep discomfort pain-free or mild, ensuring any ache settles within 15 minutes of stopping. If symptoms worsen or remain aggravated, reduce the resistance, hold duration or knee bend.
Phase 2: Heavy Slow Resistance Training
Once you tolerate isometric loading and you are pushing near maximum force at 90 degrees and the ache is settling within 15-minutes, then it is time to progress. The next phase introduces heavy slow resistance training. The aim is to progressively increase the tendon’s capacity to manage the forces involved in everyday activities and sport.
Exercises to try include:
Squats: Progressively increase resistance as your strength improves.
Lunges: Develop strength through controlled knee bending.
Leg extensions: Use a machine to progressively load the quadriceps and patellar tendon.
Perform 3 sets of 4–8 repetitions, taking three to four seconds to lower the weight during each repetition. Choose a resistance that challenges you while allowing controlled movement and good technique.
Begin with two sessions per week. After approximately two weeks, consider increasing to three sessions if your knee is recovering well between workouts.
Progress the load gradually and keep the repetitions per set low, you could even trial 3-5 reps per set! Monitor your symptoms during exercise and over the following 24 hours.
Phase 3: Plyometric Training and Return to Sport
The final phase prepares your tendon for the faster, more reactive forces experienced during running, jumping and changing direction.
Continue heavy slow resistance training, reducing the volume to 2 sets of 3-6 repetitions, twice per week, while introducing plyometric exercises.
Start with:
Hop and stick: Perform a small hop and land under control, holding the landing.
Pogos: Perform small, repeated ankle-driven jumps.
Ankling drills: Use short, rhythmic contacts to develop lower-limb stiffness and coordination.
As your strength and tolerance improve, gradually progress towards drop jumps and small-sided reactive agility drills.
Increase jump height, speed, repetitions and complexity progressively. Before returning to unrestricted sport, aim to tolerate increasingly demanding jumping, landing and change-of-direction tasks without a significant symptom flare.
How Long Does Patella Tendinopathy Take to Improve?
Recovery varies depending on symptom severity, training demands and how long the problem has been present. Meaningful improvements can take several weeks or months, so consistency and sensible load management are essential.
Importantly, you do not always need to eliminate every symptom before progressing. Instead, monitor how your knee responds and adjust your training accordingly.
Need Help With Patella Tendinopathy?
Finding the right exercises for patella tendinopathy is only part of the solution. Choosing appropriate loads, progressing at the right pace and balancing rehabilitation with sporting demands can make a significant difference.
At Tide Physiotherapy & Health, we help people understand their pain, rebuild strength and return to the activities they love through individualised rehabilitation.
Ready to get back to sport with confidence? Contact Tide Physiotherapy & Health to discuss your knee pain and develop a rehabilitation plan tailored to your goals.
References
Rio, E., Kidgell, D., Purdam, C., Gaida, J., Moseley, G. L., Pearce, A. J., & Cook, J. (2015). Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. British journal of sports medicine, 49(19), 1277-1283.
Malliaras, P., Cook, J., Purdam, C., & Rio, E. (2015). Patellar tendinopathy: clinical diagnosis, load management, and advice for challenging case presentations. journal of orthopaedic & sports physical therapy, 45(11), 887-898.
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