Patellar Tendon Load Progression during Rehabilitation Exercises

Patellar tendinopathy (jumper’s knee) is a common knee injury in athletes and active individuals, especially those involved in jumping and high-impact sports such as basketball, netball, running, football and so forth. The progression of knee patella tendon load during rehabilitation is crucial to reduce knee pain, optimise recovery, and prevent re-injury.

This recent study aimed to quantify patellar tendon load during 35 common knee rehabilitation exercises, categorising them into low, medium, and high load tiers for the patellar tendon.

4 Key Findings:

  1. Knee patellar tendon load varies significantly across exercises.
  2. The Single-Leg Decline Squat generated the highest tendon load, surpassing even running.
  3. Squat depth impacts loading:
    • 60° knee squats resulted in 50% less tendon load compared to full-depth (100°) knee squats.
  4. Load progression over time is more important than just exercise selection.
Stage 1: Low Load (Early-Stage Knee Rehab)

Purpose: Reduce knee pain, restore basic movement, and prepare for heavier loads.
Exercises:
– Walking
– Step-up (low box – 10cm step)
– Double-Leg Squat (60° knee flexion)
– Step-down (low box)
– Standard Step-up

Stage 2: Medium Load (Mid-Rehab Phase)

Purpose: Strengthen the knee tendon progressively while avoiding overload.
Exercises:
– Bulgarian Split Squat
– Single-Leg Squat (60° knee flexion)
– Full-Depth Double-Leg Squat (100° knee flexion)
– Standard Step-Down
– Running
– Drop Landings (20cm step)
– Lunge Variations
– Alternating Split Jumps
– Double-Leg Countermovement Jump (CMJ)

Phase 3: High Load (Return to Sport Phase)

Purpose: Prepare the knee tendon for high-performance movements and prevent re-injury.
Exercises:
– Single-Leg Maximal Forward Hop
– Single-Leg Countermovement Jump (CMJ)
– Single-Leg Drop Jump (20cm step)
– Single-Leg Decline Squat (90° knee flexion, upright trunk)
– Full-Speed Sprint with Cutting (45° direction change)

Important points:

  • The SL Decline Squat (90°) was the only squat exercise that produced more tendon load than running.
  • Depth and control matter: Shallow squats (60°) produce half the load of deeper squats (100°).

If you are suffering from knee tendon pain or anterior knee pain, book in with one of our expert physiotherapists who can guide you with an individual rehabilitation program to get you back to your best. We carefully modify intensity, reps, and tempo to prevent flare-ups and support you to get back to your activity.

Call our friendly staff on the number below to book in:
Tullamarine Clinic: 9116 8691 – 1/191 Melrose Drive, Tullamarine, 3043
Carlton Clinic: 9116 8693 – 2/221 Drummond Street, Carlton, 3053

TPC

Creaky Knees: Should You Be Worried?

Creaky Knee, Knee crepitus, or the grating, cracking, or popping sounds around the knee, can be unsettling, but is it really cause for concern? A recent survey explored how people with knee crepitus or creaky knee perceive it, and how their beliefs may impact their activity levels and exercise habits.

Key Takeaways: Most people don’t consider knee crepitus or creaky knee a major issue, especially when there is no pain associated with the creaky knee. However, some worry that knee crepitus may signal joint damage, leading them to avoid certain movements and reduce physical activity. These concerns are often based on misconceptions that can affect how active people stay, which may lead to more knee issues then the creaky knee.

What Can Physiotherapists Do? As physiotherapists, we can play a crucial role in addressing these misconceptions and beliefs around the creaky knee. By reassuring clients about the safety of exercise, explaining what crepitus typically means, and guiding them toward beneficial, knee-friendly activities, we can help them stay active without fear.

With the right approach, clients can feel confident in maintaining movement, preserving knee function, reducing pain and improve physical performance even if their knees are a little “creaky.” At The Physio Crew we openly discuss patient belief regarding their condition and support them with a recovery plan to achieve their health goals with evidence based practice. Call you friendly staff to book an appointment on 9116 8691 (Tullamarine ) or 9116 8693 (Carlton).

TPC