Non-Operative — Patellar Tendinopathy (Non-Operative)

University of Delaware Physical Therapy · UDPT Clinical Team

Weight-Bearing

Full WB throughout; pain-monitored progressive loading

Key Restrictions

Pain monitoring model: ≤5/10 during exercises; ≤5/10 after session (must return to baseline by next morning); baseline pain must not increase week to week; isotonic exercises every other day; isometrics daily PRN; NMES if quad index < 80%

Timeline & Phases

Phase I (Acute: isometrics 5x45 sec holds when isotonic pain > 5/10); Phase II (Recovery: HSR 3-4 sets 15RM to 6RM every other day when pain < 5/10); Phase III (Rebuilding: eccentric/unilateral progression + decline squat program 3x15); Phase IV (Return to Activity: jump/landing, acceleration, cutting, sport-specific)

Notes

University of Delaware PT Clinic; non-operative; pain at inferior pole of patella worsening with knee extensor load especially jumping; single-leg decline squat test (25° board, 0-50°) for diagnosis and monitoring; VISA-P outcome measure; differential: fat pad irritation, patellofemoral pain, joint pain; Phase I isometrics: knee extension 30-60°, Spanish squats, wall sits 45-90°; Phase II HSR: leg press, squat, hack squat with 3 sec eccentric + 3 sec concentric; noxious stim for pain modulation (>150us, >50pps); NMES at 60° until QI ≥ 80%

Surgeon / Author

UDPT Clinical Team