Jeremy Swisher, MD
Evidence-informed home exercise program
Patellar Tendinopathy Exercise Program for Athletes
Name: __________________________________
Affected side: ______________
Start date: __________________
Review date: _________________
Clinician or PT: ______________________________
Before you start
This starter program is intended for athletes who have already been evaluated and told patellar tendinopathy is the likely diagnosis. It is not intended for an acute tendon tear, a swollen or locked knee, or younger athletes with growth-center pain.
This program may fit
Localized pain at the lower pole of the patella or along the patellar tendon, reproduced by jumping, landing, acceleration, deceleration, deep squatting, or resisted knee extension.
Get assessed first
Diffuse pain around or behind the kneecap, substantial joint swelling, locking, instability, acute trauma, pain at the tibial tubercle or growth center, fat-pad pain, or symptoms suggesting inflammatory disease.
Stop signs
Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Seek same-day urgent assessment for new one-sided calf swelling, a sudden pop with inability to perform a straight-leg raise, a palpable tendon defect, rapid traumatic swelling, inability to bear weight, a locked knee, or a new painful, hot, red, or swollen joint with or without fever.
Check the next morning
A repeatable load test, such as a decline squat, can help track the tendon. Mild pain can be acceptable when movement stays normal and the tendon returns to its usual baseline by the next morning. These numbers are practical monitoring guides, not validated universal thresholds.
Fit and safety
Confirm this is the right diagnosis.
This starter program is intended for athletes who have already been evaluated and told patellar tendinopathy is the likely diagnosis. It is not intended for an acute tendon tear, a swollen or locked knee, or younger athletes with growth-center pain.
This program may fit
Localized pain at the lower pole of the patella or along the patellar tendon, reproduced by jumping, landing, acceleration, deceleration, deep squatting, or resisted knee extension.
Get assessed first
Diffuse pain around or behind the kneecap, substantial joint swelling, locking, instability, acute trauma, pain at the tibial tubercle or growth center, fat-pad pain, or symptoms suggesting inflammatory disease.
Do not self-start with these warning signs
Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Seek same-day urgent assessment for new one-sided calf swelling, a sudden pop with inability to perform a straight-leg raise, a palpable tendon defect, rapid traumatic swelling, inability to bear weight, a locked knee, or a new painful, hot, red, or swollen joint with or without fever.
This is a diagnosis-specific home program, not a substitute for an examination. A clinician may change the exercise, dose, range, or timeline based on your history.
Your home program
Build strength before progressing to jumping.
Do not begin every exercise at full volume. Begin with the isometric on higher-irritability days or two slow-strength movements on nonconsecutive loading days. Once slow strength begins, use the isometric on alternate or recovery days, or as a brief warm-up only when it reliably helps. Count isometrics, strength, jumping, practice, and competition together when judging the next-morning response. Add low-level jumping only after slow loading is controlled, baseline symptoms are stable, and there is at least forty-eight hours between early high tendon-load sessions.
- Frequency
- Strength 3 days per week; jumping initially 2 days per week
- Equipment
- Wall, chair, backpack or weights, optional band or gym equipment; use a Spanish-squat strap only with a fixed, load-rated anchor
- First checkpoint
- Adjust at 4 to 6 weeks; judge the strength trial near 12 weeks
- Primary goal
- Jumping, landing, sprinting, deceleration, and full training capacity
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Exercise 1Daily in the initial isometric stage; on alternate or recovery days once slow strength begins
Spanish squat or wall-sit isometric
Dose5 holds of 30 to 45 seconds with 1 to 2 minutes of rest
Use a wall sit unless a clinician has shown you a secure Spanish-squat setup using a purpose-built strap attached to a fixed, load-rated anchor. Do not attach an improvised strap to furniture or a door handle. Keep the trunk tall and hold at a tolerable knee angle.
Make it easierUse a shorter hold, shallower knee angle, or bilateral wall sit.
Progress itIncrease hold time, knee angle, or resistance without worsening the next-morning tendon test.
My starting dose or notes
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Exercise 23 nonconsecutive days per week
Slow squat or leg press
DoseStart with 3 sets of 12 to 15 repetitions
Lower for about 3 seconds and rise for about 3 seconds through a tolerable range. Keep the knee tracking over the middle toes.
Make it easierUse a bilateral box squat, shallower range, or lighter load.
Progress itIncrease load while moving gradually toward 4 sets of 6 to 8 repetitions.
My starting dose or notes
-
Exercise 32 to 3 days per week
Slow split squat
Dose3 sets of 6 to 12 repetitions per side
Keep the front foot grounded and lower slowly with the knee tracking over the middle toes. Use support if needed for balance.
Make it easierUse a shorter depth, hand support, or more assistance from the back leg.
Progress itAdd range, backpack or dumbbell load, then emphasize the front leg.
My starting dose or notes
-
Exercise 42 to 3 days per week
Resisted knee extension
Dose3 sets of 8 to 15 repetitions
Use a band, ankle weight, or machine. Straighten and lower the knee slowly without snapping into extension.
Make it easierUse lighter resistance or a shorter tolerable arc.
Progress itIncrease resistance and work gradually toward a heavier 6 to 8 repetition range.
My starting dose or notes
-
Exercise 52 days per week with at least 48 hours between sessions
Landing drill to low pogo jumps
DoseBegin with 2 to 3 sets of 10 controlled contacts
Start with a quiet landing and hold. Progress to small, quick bilateral pogo jumps while maintaining alignment and a spring-like ankle and knee strategy.
Make it easierPractice a landing without a rebound jump.
Progress itAdd rebound speed, then height, then single-leg or multidirectional contacts. Change only one variable per session.
My starting dose or notes
-
Exercise 61 to 2 days per week after low-level jumping is tolerated
Sport-specific jump and acceleration exposure
DoseBegin with 3 to 5 sets of 3 to 5 high-quality efforts
Select a jump, landing, sprint, or deceleration pattern required by the sport. Track the number, intensity, surface, and next-morning response.
Make it easierReduce speed, height, approach distance, or total efforts.
Progress itIncrease either intensity or volume, one variable at a time, then build repeated efforts and reduce the rest between efforts gradually.
My starting dose or notes
Optional video companion
See the movement principles in context.
The written program above remains the prescription. This independent third-party video adds a visual explanation of the condition and common exercise options.
E3 Rehab video
Patellar Tendinopathy / Tendinitis / Tendinosis | Jumper’s Knee Rehab (Education, Myths, Exercises)
YouTube content does not load until you choose this button.
A visual overview of patellar tendinopathy, load monitoring, slow resistance, jumping progressions, and return to sport.
Watch on YouTube (opens in a new tab)Use this video for education and technique, not as a second exercise program. Follow the exercises, dose, progression, and symptom rules on this page. Video examples are options, not additions. Links or promotions inside the video are provided by E3 Rehab and are not part of this program. The exercises are stage choices, not one workout. Begin with the isometric on higher-irritability days or two slow-strength movements on nonconsecutive loading days. Once slow strength begins, use the isometric on alternate or recovery days, or as a brief warm-up only when it reliably helps. Never improvise a Spanish-squat anchor, and delay jumping or sprinting until slow loading is stable with at least 48 hours between early high-load sessions.
Symptom response
Let the next day guide the dose.
A repeatable load test, such as a decline squat, can help track the tendon. Mild pain can be acceptable when movement stays normal and the tendon returns to its usual baseline by the next morning. These numbers are practical monitoring guides, not validated universal thresholds.
Green light
Pain stays near 3 out of 10 or less, movement remains normal, and the tendon is back to its usual baseline the next morning.
Yellow light
Pain rises across sets, landing strategy changes, or the standard load test is meaningfully worse the next morning. Reduce weight, range, jump intensity, or contact count.
Red light
Stop. Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Seek same-day urgent assessment for a sudden sharp pain or pop, new knee-extension weakness, rapid swelling, or inability to perform a straight-leg raise.
Change one variable at a time
When symptoms are too reactive, first reduce range, resistance, repetitions, or frequency. When the current dose feels controlled for several sessions, progress only one of those variables.
Progression
Build capacity in stages.
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Stage 1: control sudden increases in load
Reduce the most provocative jump, sprint, or competition volume while maintaining tolerable conditioning and skill work.
-
Stage 2: build slow strength
Progress from isometrics to slow controlled strength exercises. Over time the exercises should become meaningfully heavy while the tendon returns to its usual baseline by the next day.
-
Stage 3: restore jumping and other fast loading
Add landings, pogo jumps, hops, accelerations, and decelerations with planned repetition counts and recovery days.
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Stage 4: return to sport and performance
Progress from individual drills to partial training, full training, competition, and then the workload needed for performance.
Signs you are ready for the next stage
- The repeatable tendon load test stays near 2 to 3 out of 10 or less.
- High-intensity loading returns to baseline by the next morning.
- The knee has full motion without swelling or a limp.
- Quadriceps strength and hop or jump capacity are approaching the other side and relevant sport benchmarks, often using 90 percent as one part of the decision, with acceptable movement quality. Symmetry alone can be misleading when both sides are deconditioned.
- Repeated full training sessions are tolerated without limping, avoiding the involved leg, or changing movement.
When to schedule an evaluation
No single validated return-to-sport test exists for patellar tendinopathy. Review loading and technique at four to six weeks. Reassess the diagnosis and program when there is no meaningful improvement after eight to twelve weeks of consistent progressive loading, or when jump volume, strength deficits, or return-to-sport demands require individualized testing.
Call UCLA Orthopedics at 310-319-1234Progress tracker
Use this tracker through the first checkpoint above. Mark up to three key sessions each week, check weekdays for frequent work, and note symptoms, resistance, duration, or activity gains. Continue through a longer condition-specific trial when useful.
| Week | Key sessions | Daily or most-day work | Notes | ||
|---|---|---|---|---|---|
| 1 | 2 | 3 | |||
| 1 | MTWTFSS | ||||
| 2 | MTWTFSS | ||||
| 3 | MTWTFSS | ||||
| 4 | MTWTFSS | ||||
| 5 | MTWTFSS | ||||
| 6 | MTWTFSS | ||||
Common questions
Questions about this program
Should I stop sport completely?
Usually not. Relative load reduction is preferred when training does not worsen the next-day response. Avoid sudden increases in jumping volume and count strength, jumping, practice, and competition as tendon load.
Are isometrics the best treatment?
Isometrics may temporarily reduce pain for some athletes. Progressive loading is commonly recommended, but the best contraction type and dose remain uncertain.
Must I perform decline squats?
No. A decline squat is useful as a load test and can be an exercise, but progressive loading can also use squats, split squats, leg press, and knee extension.
When can jumping begin?
Begin after slow strength is controlled and baseline symptoms are stable. Start with low contacts, preserve recovery days, and check the tendon the next morning.
Do imaging findings determine readiness?
No. Diagnosis and progression are primarily clinical because tendon changes can be present in athletes without pain and structural change does not consistently track recovery.
Evidence
Guidelines, reviews, and clinical studies
This plan translates current clinical guidance into a practical home program. The cited sources support the treatment principles, but they do not establish one universal exercise recipe for every patient.
- Dutch Multidisciplinary Guideline for Patellofemoral Pain and Patellar Tendinopathy, 2025 (published online 2024) (opens in a new tab)
- Breda et al.: Progressive Tendon-Loading Exercise Versus Eccentric Exercise, Randomized Trial (opens in a new tab)
- Clinical Management of Patellar Tendinopathy (opens in a new tab)
- Malliaras et al.: Patellar Tendinopathy Diagnosis, Load Management, and Advice for Challenging Cases (opens in a new tab)
- Patellar Tendon Load Progression During Rehabilitation Exercises, 2024 (opens in a new tab)
- Cochrane Review: Exercise for Patellar Tendinopathy, 2025 (opens in a new tab)
- Network Meta-analysis of Exercise for Patellar Tendinopathy, 2026 (opens in a new tab)
Evidence and recommendations can change. Last clinical review: August 28, 2026.