Patellar Tendon Pain Exercises: Build Strength & Load Tolerance
By Madison Bennett
BSc Sport & Exercise & MSc Physiotherapy
Pain at the front of the knee, particularly just below the kneecap, is commonly associated with patellar tendon pain (often referred to as jumper’s knee). This condition is frequently seen in running and jumping-based activities, where repeated loading of the tendon exceeds its current capacity.
Rather than being purely “inflammatory,” patellar tendon pain is best understood as a load management issue. This means the tendon is being asked to do more than it is currently prepared for, whether that’s due to spikes in training volume, intensity, or insufficient strength in the surrounding muscles.
A structured, progressive strengthening approach is key to both reducing pain and restoring function.
We will move through isometric exercises first to help reduce pain while still allowing the tendon to be loaded safely. Then, we move on to heavy slow resistance exercises for building tendon capacity. Once pain is more manageable, progressive strength training becomes the most important component, with research showing that tendons respond well to slow, controlled, high-load exercises [1].
Instructions
Step 1
Wall Sits: Sit against a wall with knees bent (aim for ~60–90°). Hold the position while keeping weight evenly distributed through both legs. Focus on maintaining a steady hold without shifting weight away from the painful side.
Step 2
Decline Single Leg Holds: Stand on a slight decline (or wedge) and hold a single-leg squat position. This increases load through the patellar tendon and is highly specific to rehabilitation. Progression: Increase hold duration (e.g. 30 → 45 → 60 seconds), add load (dumbbells), or progress to single-leg variations.
Step 3
Split Squats: Step into a staggered stance and lower slowly, keeping the front knee tracking over the toes. Focus on controlled tempo, especially during the lowering phase.
Step 4
Step Downs: Stand on a step and slowly lower one foot toward the ground. Control knee alignment and avoid excessive inward collapse.
Step 5
Bulgarian Split Squats: With the back foot elevated, this increases load demand on the front leg and challenges both strength and control. Keep the torso upright and allow the knee to travel forward naturally. Progression: Gradually increase load, range, and intensity. Focus on slow tempo (e.g. 3–4 seconds down) to maximise tendon adaptation.
Workout Notes
This type of workout can be integrated into gym sessions, used alongside sport-specific training, or implemented as part of a structured rehabilitation plan.
Disclaimer:
This routine is for general fitness and educational purposes only and does not replace professional medical advice. Consult a qualified professional before starting or modifying training, especially if you have a history of injury or current pain.
Reference:
Moafa AIA, Jaffari AMN, Hamdi AH, Alshamrani IA, Alharbi KM, et al. The role of physiotherapy in managing patellar tendinopathy: a comprehensive review. J Int Crisis Risk Commun Res. 2024;7(S8):1739–1746. doi:10.63278/jicrcr.vi.1095