Patellar Tendon Remodeling

Patellar Tendon Remodeling

A crucial step many coaches and therapists miss when rehabilitating an athlete with Patellar Tendonitis is focused remodeling of the damaged connective tissue.

Although the symptom at the patellar is often a result of a global dysfunction or aberrant movement at an accompanying joint it is important to also address the site of tissue damage during the rehabilitation process.

After establishing and treating the dysfunction that is overloading the patellar tendon (possible lack of ankle dorsiflexion or instability of hip/mid foot?) we can begin targeting the connective tissue of the quadricep/patella tendon.

The idea of the progression below is to focus on applying stress through the damaged tissue to help guide the remodeling process. Often coaches are petrified of letting the knee go over the toes during squatting movements, especially with clients who have a history of knee pain. This fear is misguided. Knees over the toes isn’t bad, uncontrolled knees over the toes is bad. We don’t sprint and play sports with a vertical tibia. To ensure we are prepared for athletic movements we have to train with a positive shin angle. With intelligent application the following progression has proven very successful for me in helping athletes return from Patellar Tendonitis. I often precede the progression below with PAILS/RAILS in the classic “heel to butt” quad stretch position.

Clockwise starting in the top left box:

Isometric Split Squat Hold ➡️ Supported Eccentric Valslide Lunge ➡️ Eccentric Valslide Lunge ➡️ Skater Squat.

For more information about the principles that guide my treatment and training process checkout @drandreospina And his FRC and FRR courses.