Do you have pain in the front of your knee? Is it aggravated by squatting and jumping?
If so you may have patellar tendinopathy.
Patellar Tendinopathy is one of many conditions that can cause anterior knee pain. One key distinguishing factor I utilize in differentiating patellar tendon pain from other knee pathologies is that the increase in pain occurs instantly with loading and in most cases ceases almost immediately when the load is removed.(1) Pain also tends to be more severe with greater load and speed through the knee.
Example: Single Leg Hop > Double Leg Jump > Single Leg Squat > Double Leg Deep Squat.
If you have pain with any of the above activities, the pain is just below the knee cap, and this pain increases with increasing force through the knee there's a good chance you have patellar tendinopathy.
🎉The good news is that there are well researched and highly effective treatment options to eliminate this pain.
The first of which are called isometrics. This type of exercise involves contracting a muscle without producing any movement at the joint.
As a Doctor of Physical Therapy these are my go to exercises for those who have moderate levels of pain (3-5/10) with squatting, step ups, and lunges.
🔥It typically only takes 1-2 weeks of consistent isometric training to alleviate the majority of pain with squatting🔥
Once squatting has less than 3/10 pain, we move on to phase 2 of the 4 phase rehab protocol. If you want to learn more about phase 2 check out next weeks blog post.
✅Isometric Wall Sits:
5x45 seconds
2-4x/day until pain levels are 0/10 at rest and <3/10 with body weight squats.
Intensity is of utmost importance, tendons need high loads to adapt and heal. This requires the wall sits to be at a 7/10 difficulty at the end of each set, where 10/10 is absolute max capacity, while also respecting pain levels. Start on step 1 of the wall sit progression and if 45 seconds isn't 7/10 difficulty progress to the next step until you find the right intensity.
⭐️Wall Sit Progression⭐️
1️⃣ ¼ Wall Sit with Feet in Front of the Knees
2️⃣ ¼ Wall Sit with Feet Behind the Knees
3️⃣ Parallel Wall Sit with Feet in Front of the Knees
4️⃣ Parallel Wall Sit with Feet Behind the Knees (Brutally Hard)
Your Knees Thank You for Reading,
Dr. Dylan Webster, PT, DPT, OCS, XPS, CCI
References
Malliaras et al. J Orthop Sports Phys Ther 2015;45(11):887–898. Epub 21 Sep 2015. doi:10.2519/jospt.2015.5987
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