Restore Patellar Tendon

Isometrics

5x45s holds; pain must settle within 24 hours

- Use when pain is >5/10

- Manual resistance; Spanish

squat, wall sits, TKE squats

Isotonics

Pain < 3-5 /10

3 sets 10-15 reps 3x/week (isometrics should be done every day)

Sit to stands, TKE (double leg if using body weight; single leg if using equipment for resistance), split squats, step downs, decline squats (my favorite for this part)

Eccentric exercises

Improve the stress the tendon can handle (pain of 3-5 out of 10 is ok to be monitored; if >5/10 decrease load or increase rest periods between sets

Heavy Slow Resistance Training

- 3 exercises: Squats, Leg press, decline board goblet Squats; heavy weight, slow movement (3s down, 3s at bottom and 1s up)

- Begin light light and for 15 reps progressing to 6 reps max

My favorite -> decline board, ideal between 15° and 30°

Functional Movements (sports specific)

When you can perform 4-8 repetitions of a single leg press at

150% bodyweight

You can try stage three exercises; but pain must be <3/10 and symptoms must settle within 24 hours.

- Hopping (jump rope), landing (depth drops), changing directions (defensive line drill), cutting (stop and go movements), acceleration and deceleration (split stance start to sprint steps abrupt stop in split stance or two step to take off penultimate step jumps)

- “You can return to sport” if they can handle 3 sessions of high load, sport specific movements with no symptoms within 24 hours (this is subjective and I use it for my athletes that have high usage rates… example practice everyday and play high minutes in games)