Patellar tendinopathy rehab: Is progressive loading therapy or eccentric therapy more effective?

Research reviewed: Effectiveness of progressive tendon-loading exercise therapy in patients with patellar tendinopathy: a randomised clinical trial (Breda et al. BJSM Nov 2020)

This week’s paper compared two different types of exercise therapy - progressive tendon-loading exercises (PTLE) and eccentric exercise therapy (EET) - in patients suffering from patellar tendinopathy.

PTLE consists of exercises that incrementally increase load on the tendon via different types of exercise - from isometric to concentric to eccentric. On the other hand, EET focuses only on eccentrics.

Methods

76 patients with clinically diagnosed and ultrasound confirmed patellar tendinopathy (median age 24 years and median symptom duration 2 years) were randomly assigned at a 1:1 ratio to complete either PTLE or EET.

The patients were assessed prior to starting the program and after 24 weeks via the VISA-P questionnaire - a validated measure for pain, function, and ability to play sports.

Secondary outcomes were return to sports rate, subjective patient satisfaction, and exercise adherence.

Results

The improvement in the PTLE group was significantly higher than the EET group, with higher scores on the VISA-P and higher return to sports rate.

Practical takeaways

Progressive loading seems to be the more effective and worthwhile option for those suffering from patellar tendinopathy, particularly chronic patellar tendinopathy.