So, you’re doing your patellar tendonitis rehab exercises diligently, and you’re careful not to overcook things because your physio has warned you that this would be counterproductive. Yet your patellar tendon pain isn’t going away, or it flares up at unexpected times. What could be the matter? Here are some everyday movements that may be to blame and that you may want to avoid during your patellar tendonitis rehab. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call.
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Patellar tendon pain rehab – looking beyond exercises
Injured tendons don’t like being stretched and they don’t like being compressed. If your physio knows what they’re doing, they would have ensured that your patellar tendon rehab programme avoids exercises that would do this to your tendon and cause you pain. They would also have warned you against overdoing those exercises that they did prescribe, because that will have the same effect.
If this is the case and your tendon is still painful or flares up in spite of good progress with the rehab programme, it makes sense to look beyond the exercises; there may be some everyday activities that cause you ongoing patellar tendon pain.
We warn our patients against two such movements or activities and advise them how to adapt things to avoid irritating their recovering patellar tendons: kneeling and squatting.
How kneeling can cause pain
Gardening, working with small children or animals, washing the floor, DIY – all these activities might require you to kneel from time to time.
The quadriceps muscles on the front of your thigh end in the quadriceps tendon just above the kneecap or patella. The patellar tendon runs from the lower border of the kneecap and attaches to the top of your shin bone or tibia.
When you’re kneeling, you’re kneeling right on that injured patellar tendon, and this compresses it against the bones in your knee joint.
And, depending on how far your knee is bent while you’re kneeling, the tendon might also get stretched, which will make matters even worse.
How deep squatting can increase pain
Similarly, if you are squatting to do jobs or activities that are low down or to deal with something that needs you to be in this position, the patellar tendon is being pulled tight over the bony bits in your knee joint, causing it to be compressed and stretched.
This is also why your physio will likely ask you to not squat too low when you do your rehab exercises in the early stages of your recovery.
Workarounds
Where possible, avoid compressing and/or stretching your injured patellar tendon by sitting on the floor or on a low stool instead of kneeling and squatting. If you can manage to sit with straight legs or knees that aren’t bent too much, even better.
These are only temporary measures. Your rehab exercises will gradually restore your tendon’s ability to withstand both compression and stretch, and you’ll be able to do these activities without any problems once you’ve recovered.
How we can help
Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Steph is a chartered physiotherapist with more than 15 years' experience and a Master’s Degree in Sports and Exercise Medicine. You can read more about her here, and she's also on LinkedIn.