There are several different exercises that can be utilized in order to help with patellar tendonitis. Patellar tendonitis is an injury to the tendon that connects the patella, or kneecap, to the shinbone.
Below we will explore the best exercises for this particular injury by investigating;
- Exercises for patellar tendonitis
- Massage for patellar tendonitis
- Treatment for the condition
- Recovery time
- Symptoms of patellar tendonitis
- Braces for patellar tendonitis
Exercises for patellar tendonitis
1. Straight-leg raises to the front
Lie on your back with your good knee bent so that your foot rests flat on the floor. Your affected leg should be straight. Make sure that your low back has a normal curve.
You should be able to slip your hand in between the floor and the small of your back, with your palm touching the floor and your back touching the back of your hand.
Tighten the thigh muscles in your affected leg by pressing the back of your knee flat down to the floor. Hold your knee straight.
Keeping the thigh muscles tight and your leg straight, lift your leg up so that your heel is about 1 foot off the floor.
Hold for about 6 seconds, then lower your leg slowly. Rest for up to 10 seconds between repetitions.
Repeat 8 to 12 times.
2. Short-arc quad
Lie on your back with your knees bent over a foam roll or large rolled-up towel and your heels on the floor.
Lift the lower part of your affected leg until your leg is straight. Keep the back of your knee on the foam roll or towel.
Hold your leg straight for about 6 seconds, then slowly bend your knee and lower your heel back to the floor. Rest for up to 10 seconds between repetitions.
Repeat 8 to 12 times.
3. Half-squat with knees and feet turned out to the side
Stand with your feet about shoulder-width apart and turned out to the side about 45 degrees. Keep your back straight, and tighten your buttocks.
Slowly bend your knees to lower your body about one-quarter of the way down toward the floor. Try to keep your back straight at all times, and do not let your pelvis tilt forward or your knees extend beyond the tip of your toes.
Repeat 8 to 12 times.
4. Step-up
Place a single-step footstool on the floor. If you do not have a footstool, you can use a thick book, such as a phone book, a dictionary, or an encyclopedia. If you are not steady on your feet, hold on to a chair, counter, or wall while you do this exercise.
Keeping your back straight, step up with your affected leg. Try not to push off your back leg as you step up. Only use your affected leg to bring you up on to the step. Then lift your other leg on to the step. As you step up, try to keep your knee moving in a straight line with your middle toe.
Move back to the starting position, with both feet on the floor.
Repeat 8 to 12 times.
#5- Step-down
Stand on a single-step footstool. If you do not have a footstool, you can use a thick book, such as a phone book, a dictionary, or an encyclopedia.
If you are not steady on your feet, hold on to a chair, counter, or wall while you do this exercise. Slowly step down with your good leg, allowing your heel to lightly touch the floor. As you step down, try to keep your affected knee moving in a straight line toward your middle toe.
Move back to the starting position, with both feet on the footstool or book.
Repeat 8 to 12 times.
6. Terminal knee extension
Tie the ends of an exercise band together to form a loop. Attach one end of the loop to a secure object, or shut a door on it to hold it in place.
Loop the other end of the exercise band around the knee of your affected leg. Keep that leg somewhat bent at the knee.
Put your good leg about a step behind your affected leg. Then slowly straighten your affected leg by tightening the thigh muscles of that leg.
Hold for about 6 seconds, then return to the starting position, with your knee somewhat bent.
Rest for up to 10 seconds. Repeat 8 to 12 times.
7. Standing hamstring stretch
Put the heel of the leg on your injured side on a stool about 15 inches high. Keep your leg straight.
Lean forward, bending at the hips, until you feel a mild stretch in the back of your thigh. Make sure you don’t roll your shoulders or bend at the waist when doing this or you will stretch your lower back instead of your leg.
Hold the stretch for 15 to 30 seconds. Repeat 3 times.
8. Quadriceps stretch
Stand at an arm’s length away from the wall with your injured side farthest from the wall. Facing straight ahead, brace yourself by keeping one hand against the wall.
With your other hand, grasp the ankle on your injured side and pull your heel toward your buttocks. Don’t arch or twist your back. Keep your knees together.
Hold this stretch for 15 to 30 seconds.
9. Side-lying leg lift
Lie on your uninjured side. Tighten the front thigh muscles on your injured leg and lift that leg 8 to 10 inches away from the other leg. Keep the leg straight and lower it slowly. Do 2 sets of 15.
10. Rectus femoris stretch
Kneel on your injured knee on a padded surface. Place your other leg in front of you with your foot flat on the floor. Keep your head and chest facing forward and upright and grab the ankle behind you.
Gently bring your ankle back toward your buttocks until you feel a stretch in the front of your thigh. Hold 15 to 30 seconds. Repeat 2 to 3 times.
11. Prone hip extension
Lie on your stomach with your legs straight out behind you. Fold your arms under your head and rest your head on your arms. Draw your belly button in towards your spine and tighten your abdominal muscles. Tighten the buttocks and thigh muscles of the leg on your injured side and lift the leg off the floor about 8 inches.
Keep your leg straight. Hold for 5 seconds. Then lower your leg and relax. Do 2 sets of 15.
12. Clam exercise
Lie on your uninjured side with your hips and knees bent and feet together. Slowly raise your top leg toward the ceiling while keeping your heels touching each other. Hold for 2 seconds and lower slowly. Do 2 sets of 15 repetitions.
13. Wall squat with a ball
Stand with your back, shoulders, and head against a wall. Look straight ahead. Keep your shoulders relaxed and your feet 3 feet from the wall and shoulder’s width apart. Place a soccer or basketball-sized ball behind your back. Keeping your back against the wall, slowly squat down to a 45-degree angle.
Your thighs will not yet be parallel to the floor. Hold this position for 10 seconds and then slowly slide back up the wall. Repeat 10 times.
Build up to 2 sets of 15.
14. Knee stabilization
Wrap a piece of elastic tubing around the ankle of your uninjured leg. Tie a knot in the other end of the tubing and close it in a door at about ankle height.
Stand facing the door on the leg without tubing (your injured leg) and bend your knee slightly, keeping your thigh muscles tight. Stay in this position while you move the leg with the tubing (the uninjured leg) straight back behind you. Do 2 sets of 15.
Turn 90 degrees so the leg without tubing is closest to the door.
Move the leg with tubing away from your body. Do 2 sets of 15.
Turn 90 degrees again so your back is to the door. Move the leg with tubing straight out in front of you. Do 2 sets of 15.
Turn your body 90 degrees again so the leg with tubing is closest to the door. Move the leg with tubing across your body. Do 2 sets of 15.
Hold onto a chair if you need help balancing. This exercise can be made more challenging by standing on a firm pillow or foam mat while you move the leg with tubing.
15. Resisted terminal knee extension
Make a loop with a piece of elastic tubing by tying a knot on both ends. Close the knot in a door at knee height. Step into the loop with your injured leg so the tubing is around the back of your knee. Lift the other foot off the ground and hold onto a chair for balance, if needed.
Bend the knee with tubing about 45 degrees. Slowly straighten your leg, keeping your thigh muscle tight as you do this. Repeat 15 times. Do 2 sets of 15. If you need an easier way to do this, stand on both legs for better support while you do the exercise.
16. Decline single-leg squat
Stand with both feet on an angled platform or with your heels on a board about 3 inches high. Put all of your weight on your injured leg and squat down to a 45-degree angle. Use your other leg to help you return to a standing position from the squat. You should lower your body to a squat using only your injured leg but you can use both legs to return to standing.
When this exercise gets easy, hold weights in your hands to make the exercise more difficult. Do 2 sets of 15.
Patellar tendonitis massage
Patellar tendonitis massage helps to increase the circulation, decreases tension in the surrounding muscles, and increase flexibility and strength. This will certainly assist with the healing process.
In chronic cases, cross fiber friction massage of the tendon is a great place to start. From here you may also massage the quadriceps, hamstrings, glutes, and gastrocnemius muscles that surround the kneecap and hold it in place.
You should treat these trigger points to relax the muscles to decrease the tension.
Chronic pain patellar tendonitis treatment
The treatment path for each person depends on the severity of the injury. Conservative methods for pain relief, such as rest, stretching, and strengthening your leg muscles are the first line of treatment.
Doctors will usually advise a period of controlled rest, avoiding activity that will put any force on the knee.
Medication
To deal with the pain you are experiencing, your doctor may prescribe some over the counter anti-inflammatory medication.
This may include ibuprofen (Advil), naproxen sodium (Aleve), and acetaminophen (Tylenol). If the pain is extremely severe your doctor may prescribe a corticosteroid injection around your patellar tendon. This is effective in reducing pain however it can cause a rupture in the tendon.
Corticosteroids are also able to be administered with considerably less risk than the injection. It is absorbed through the skin through a process called iontophoresis.
OTC medications are generally the first point of call, well before surgery is even considered. This, in conjunction with physical therapy, will in most less severe cases be enough to promote healing.
Therapy
Physical therapy aims to reduce pain and inflammation of the affected area as well as stretch and strengthen the leg and thigh muscles.
If you are recommended to rest then the doctor may also advise a brace for your injured knee joint and crutches to assist with walking. This will prevent unwanted stress and pressure on the knee.
Physical therapy can be commenced once you are relatively pain-free. A session may include a warm-up period, ice or massage, stretching exercises, and strengthening exercises.
An ultrasound or electrical stimulation may also be used by your therapist to ease the knee pain. Taping or a knee brace can be used with physical therapy to give your knee extra support and will also keep your kneecap in place.
This can help: How long to apply ice to knee tendonitis?
Alternative treatments
Platelet-rich plasma injections are a relatively new treatment but is quickly gaining momentum in the medical field. It uses a concentration of platelets from your own blood to promote healing in the area to which it is injected, in this case, the tendon.
Other alternative treatments include;
- Ultrasound-guided dry needling: This process makes small holes in the tendon. This is called dry needle fenestration and has been found to relieve pain and help to heal.
- Injections with polidocanol: This aims at breaking up new blood vessels on the tendon, which are associated with pain.
- High volume ultrasound-guided injections: This also aims at breaking up new blood vessels on the tendon.
- Hyperthermia thermotherapy: This uses deep-tissue heating along with a cooling device on the skin surface to relieve pain.
- Extracorporeal shockwave therapy: This has shown to reduce pain for up to two years.
Surgery
When all other treatments fail to relieve pain, your doctor may recommend surgery to repair the patellar tendon.
Traditional surgeries involve opening the knee to scrape the kneecap and tendon. Arthroscopic surgery is used in more modern procedures. This involves making four small incisions in the knee and it has a significantly shorter recovery time.
Recovery tie after surgery varies greatly between patients. In three months to a year, patients can return to high-level activity.
Patellar tendonitis recovery time
The recovery time for patellar tendonitis will vary depending on the individual and the severity of the injury. It is such a common injury in runners and athletes so it is constantly the subject of new research.
There are many conflicting opinions on rehabilitations among professionals. For athletes, the condition is often chronic which means that they may never be able to return to their sport. For others, therapy may allow them to return to their everyday lives with a full range of motion.
Recovery can be anywhere between 3 weeks and 8 months.
Important factors in recovery are:
- Sticking to your rehabilitation program and regularly exercising
- Resuming your sports activity gradually
- Paying attention to pain, and resting as necessary
- Using OTC remedies and ice to help with returning pain
Speak with your doctor if you have concerns about how long your recovery is taking.
Patellar tendonitis symptoms
The first symptom of patellar tendonitis is pain and tenderness around the kneecap. It may also present swelling and a burning sensation around the kneecap.
Kneeling down or getting up from a squatting position can be extremely painful. The pain may not be constant and may only occur with specific motions. It could even be evident only after physical activity and exercise.
As the tendon becomes more damaged the pain can get progressively worse. It will eventually interfere with your regular exercise and sporting activities if left untreated. It will eventually extend to everyday tasks, like sitting down.
See your doctor if any pain or swelling lasts more than a day or two.
Patellar tendonitis brace
There are many patellar tendonitis braces on the market, but how do you know that you are getting the right one for you? There are a few things that you should be looking for when buying your knee brace to ensure it provides the proper support.
Reinforced support on either side of the knee is imperative, and padding beneath is an added bonus to make sure the brace is comfortable for long periods of wear.
Elastic hooks and straps are also great as they ensure a perfect, customized fit for your knee. It should provide compression around the patella and most of these braces come with open patella.
