Patellar Tendinopathy : Recovery Modalities and the Evidence

Progressive tendon loading. A network meta-analysis of 37 randomized trials concluded that eccentric loading should continue to be used as first-line treatment for patellar tendinopathy, with heavy slow resistance also performing well. The same review recommended against extracorporeal shockwave therapy because it was no better than sham. Nothing passive has displaced structured loading.

It has the only patellar tendinopathy trial of any modality on this page, and it is encouraging but small. In a 39-patient equivalence trial, vibration matched heavy slow resistance for pain reduction, but resistance training produced larger function gains and equivalence was inconclusive for most other measures. Worth discussing with a physio as one way to deliver load, not as a passive substitute.

There is no evidence that it fixes tendon structure. The pooled tendinopathy meta-analysis showed pain and function benefits when light was added to exercise rather than used alone, only one of its 17 trials studied the patellar tendon, and the authors graded the evidence low to very low. If you try it, treat it as an adjunct to a loading program.

Cleveland Clinic explicitly lists not playing through the pain among its prevention advice, and identifies sudden increases in intensity and insufficient recovery between sessions as the main causes. Continuing to jump on a painful tendon is how a few weeks of irritation turns into a months-long problem. Load modification is a clinical decision worth making with a physiotherapist rather than alone.

As a comfort measure, yes. Cleveland Clinic includes ice in early management for jumper's knee. What it will not do is change the underlying tendon problem: no passive physical modality ranked as an effective option in the patellar tendinopathy network meta-analysis. Use it to take the edge off after training, not as the plan.