Patellar tendon load progression during rehabilitation exercises: implications for the treatment of patellar tendon injuries

Review written by Dr Teddy Willsey info

Key Points

  1. A patellar tendon loading index was created to objectify and organize 35 lower body knee dominant exercises into low, medium, and high load.
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BACKGROUND & OBJECTIVE

The prevalence of patellar tendinopathy has been reported to be as high as one in three young athletes (1). It has been suggested that athletes with inadequate adaptation of tendon stiffness relative to increases in muscle strength may be at an increased risk of developing tendinopathy (2). Persistent patellar tendon pain following ACL reconstruction using a bone-patellar tendon-bone (BPTB) autograft is commonplace (3). Importantly, there is subset of ACL BPTB patients who struggle with anterior knee pain for many years following surgery (4).

Exercise is the most common intervention for patellar tendon pain (5). Clinicians who routinely treat athletes with patellar tendon pain would benefit from a greater understanding of patellar tendon loads during the exercises they prescribe. The purpose of this study was to determine a loading index with the goal of quantifying patellar tendon load across 35 exercises typically used in clinical rehabilitation of patients with knee disorders.

The prevalence of patellar tendinopathy has been reported to be as high as one in three young athletes.
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The findings of this paper remind us there is not one best exercise or progression protocol for patellar tendon pain.

METHODS

  • 20 healthy adults (10 M, 10 F, age 18-40) with no history of patellar tendon pain and no history of lower limb or spine injury over the past six months were recruited to analyze 35 common exercises.
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