02/16/2026
How I would treat Patellar Tendinopathy if I had it 👇
Patellar tendinopathy is super common in active people. It happens when the tendon is overloaded from too much jumping, sprinting, or other high force loading over time.
At the microscopic level you’ll see collagen disorganization, increased microvascularization, and more fluid in the tendon matrix. But practically speaking:
The tendon is irritated because it’s been asked to handle more load than it was prepared for.
One key thing.
True patellar tendinopathy is pinpoint.
Not vague anterior knee pain.
You can usually put one finger directly on the tendon and say “that’s it.”
The single leg decline squat is a great test.
Treatment sounds simple on paper. Harder in real life.
Tendons respond to load.
If you want collagen to reorganize, you have to load it. Heavily.
The good news: symptoms often improve before structural changes fully occur. Full resolution will probably take months.
Here’s my approach:
1️⃣ Activity modification
Reduce fast, high-load activities. Jumping, sprinting, rec sports.
Not always zero. But probably less.
If you keep them in, I like at least 2 recovery days between sessions.
2️⃣ Daily isometrics
Simple wall sits. 5 x 45 seconds.
Great for symptom reduction and reintroducing load.
3️⃣ Heavy slow resistance
This is where most people underdose it.
Slow tempo. Heavy load.
Push above ~70% effort.
Squats, leg extensions, split squats. Load the quads.
4️⃣ Gradual return to speed
Once heavy slow loading feels good, start reintroducing faster rates of loading.
Double leg jumps → single leg jumps.
To my fellow PTs/rehab professionals what are you adding or tweaking? 👇🏻
If you need help treating your patellar tendon pain come see us ‼️
