USE OF CRYOTHERAPY The use of specific cryotherapy splints will complement the treatment. This is an excellent pain management tool that helps optimize compliance and the effectiveness of the progressive optimal loading program. If pain is a factor limiting the patient’s ability to achieve the load required for mechanotransduction, cold analgesia is a valuable tool for optimizing the quality and intensity of exercise. Compressive cryotherapy or simply direct icing can be used.
Rehabilitation
First, the isometric loading protocol is implemented: use of high-intensity isometric contraction. This is an essential tool in the initial phase of pain management for patellar tendinopathy. Its main objective is to induce immediate hypoalgesia to create a “therapeutic window” allowing progression to more demanding strengthening exercises. Next comes eccentric muscle work (muscle contraction associated with elongation) or Heavy Slow Loads (Concentric/eccentric contractions), which are standard for the treatment of tendinopathies. Specific protocols, such as single leg decline squats, have been shown to be effective in selectively increasing the load on the patellar tendon. It is crucial that this work be done gradually and below the pain threshold to stimulate tissue healing without aggravating it. If the tendinitis only occurs at certain degrees of flexion, it will be necessary to work below or above these angles, avoiding pain.
Mobility and strengthening exercises are the cornerstone of treatment: in addition to the optimal loading strategy, core strengthening and proprioception work are essential to improve motor control and lower kinetic chain alignment in order to prevent recurrence.
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