What causes Patellar Tendonitis in the first place?
Runners get tendonitis almost as much as they get new shoes, and Patellar Tendonitis is one of the most common forms of this extremely common overuse injury. Thankfully, the cause is simple and there are a few exercises that will help you get back to running pain free in no time. We’ll talk about the cause first, then we’ll show you the three best exercises for patellar tendonitis.
The Cause. The cause of patellar tendonitis in runners is simple. You ran more than the tendon was ready for. That could mean more mileage, more speed, or just more than it was expecting (because you were under-slept, undernourished, or under-recovered). The best way to get rid of patellar tendonitis is to encourage the tendon to heal itself through exercise therapy while also increasing the overall amount of load your body can handle. That means making your legs stronger.
What happens to the tendon? When you put too much load (mileage, pace, time on feet, etc) through a tendon, it panics. The normally neat and orderly strands of collagen start to get disorganized and the whole thing thickens up. Basically the body is trying to reinforce everything as fast as possible so you don’t really get hurt. The way to get it back on track is to introduce the correct amount of load. This will tell the body that things are OK and return it to a pattern of laying down new strands of orderly, healthy collagen.
Different ways to beat patellar tendonitis
There are two common methods of loading tendons properly to help them get healthy.
Alfredson protocols – Alfredson protocols are tendon rehab programs named after the Swedish scientist who first cracked the tendonitis code in the 1980’s. They basically involve you doing 3 sets of 15 reps of bodyweight squats on a slanted board, twice a day for 12 weeks. It’s a great way to retrain the tendon. But it doesn’t work well with the demands of being a runner (or having a life).
Heavy Slow Resistance Training – This is the new wave of tendonitis rehab, and it comes from Denmark not Sweden! Instead of a billion reps every day. You lift heavy and slowly (3 seconds up, 3 seconds down) 3 times per week increasing the weight and decreasing the reps as you get stronger. Analysis shows similar outcomes between Alfredson protocols and HSR, but much higher levels of athlete satisfaction when you don’t have to do a billion reps every darn day!
The best exercises for mild patellar tendonitis
For runners with mild patellar tendonitis we use a blended strategy that consists of heavy slow quad work to focus on the tendon and additional glute strengthening exercises to encourage good biomechanics that don’t overload your knee when you run. We want to remind you that this is for the athlete whose soreness is mild. If you’ve got so much pain that you can’t run, it’s smarter to find a physical therapist who can get you started on a program like this at the exact level you need (and rule out any more serious injuries!) Start by performing 3 sets of 10 reps of these exercises, slowly and with challenging resistance, 3 times per week.
Exercise 1: Weighted Squats:
Why it works: The squat is the best way to make your legs stronger – period. Adding weight, in the form of a heavy kettlebell or barbell increases the amount of good load that goes through the patellar tendon, which will help remodel it, while you build greater strength in your legs.
Exercise 2: Split Squats
Why it works: This is one of the best ways to load the patellar tendon and strengthen the quad. Adding a single leg squat variation helps isolate a weaker side (it will most likely be the side with patellar tendonitis!) and strengthen it.
Exercise 3: Side Leg Raises
Why it works: This trains the hip external rotators – when these muscles are strong, there is less twisting force across the front of the knee. This is a MUST for relieving tendonitis pressure.
Want these exercises in a custom routine that automatically adjusts with your training? Try the Recover Athletics app for free!
