posted by jumpers_knee_jess 19d ago

Isometrics for patellar tendon pain during a season

Coaching question rather than a personal one. I have three high school players with patellar tendon pain mid season. We cannot stop the season and I am not going to pretend we can. What I currently do: heavy isometric holds before practice for pain relief, reduced jump volume, and heavy slow resistance twice a week on non game days. Everything else stays. Is that defensible or am I just doing what I did for myself and calling it coaching?

Isometrics before ice. Every time.

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Dr_Rehab_RayCleveland, OH6 points18d ago

Your approach is broadly defensible for in-season tendinopathy. Isometrics for pre-activity pain relief have decent support, though response varies. Keeping heavy slow resistance in is key so they do not lose capacity over four months and come back weaker. The main thing to fix is your jump volume tracking. "Reduced" is too vague. You need to actually count them.

Load is the drug with the best data.

CoachTerrellAtlanta, GA5 points18d ago

Count practice jumps too, not just games. Practice is where all the volume hides, and coaches always underestimate it.

You cannot inject your way out of a bad program.

jumpers_knee_jessOmaha, NE5 points18d ago

Fair point. I only tracked game jumps, which I realize now is an incomplete picture.

Isometrics before ice. Every time.

slow_healer_samBoise, ID8 points18d ago

Does the isometric hold work for everyone? I tried it and got zero pain relief, so I figured I was doing it wrong.

Still here. Still slow.

Dr_Rehab_RayCleveland, OH3 points17d ago

You probably were not doing it wrong. Analgesic response to isometrics is really variable, and newer research shows it is not guaranteed. If it gives you nothing, do not sweat it. Just focus on progressive loading and drop the expectation of instant pain relief.

Load is the drug with the best data.

jumpers_knee_jessOmaha, NE4 points16d ago

That tracks. One of my kids gets great relief, one gets a little, and one gets nothing at all.

Isometrics before ice. Every time.