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Injury Prevention

The New Way To Fight Knee Pain? Don’t Move

The most effective exercises for combatting patellar tendonitis might be the simplest.

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For those who experience knee pain, relief may be as simple as holding a squat.

According to a study published in the August 2016 issue of Clinical Journal of Sport Medicine, Australian researchers found isometric exercises—steady-state exercises, like wall sits and planks—can relieve knee pain caused by patellar tendonitis.

Typically, patients with patellar tendonitis are asked to perform a mix of isometric and isotonic (exercises that require movement) maneuvers. However, because the knee is a joint, the movement associated with isotonic exercises can sometimes aggravate pain. The result: frustrated athletes who give up on rehab.

“The isotonic exercises used for patellar tendonitis are painful to complete,” says Dr. Ebonie Rio of Australia’s Monash University. “When these exercises are given to athletes, research has shown their pain increases and their adherence to doing these exercises is poor, probably because of the pain.” Rio, along with a team of researchers, wanted to see if lower-stress isometric exercises could help fix the pain—and the compliance problem.

After recruiting 20 athletes with diagnosed patellar tendonitis, the researchers split the subjects into two groups: one set who performed isometric leg holds, and another who did isotonic leg extensions. After one week, the isometric group reported significant relief from knee pain. At the four-week mark, the isometric group had higher rates of exercise compliance than the isotonic group, in large part because they were experiencing far less pain.

That result led Rio to conclude that, “heavy isometric muscle holds reduce patellar tendon pain immediately and substantially. They are more effective for immediate pain relief than isotonic exercises.”

So does that mean we can do away with step-ups and lunges forever? Not quite. Isotonic exercises should still be a part of the patellar tendonitis rehabilitation protocol once the knee pain is reduced. Staying strong with a variety of maneuvers is an important part of training. Says Rio: “Don’t miss leg day.”

Try it: Spanish Squat

To do this isometric exercise, position a belt around a sturdy pillar, creating two loops on either side of the pillar. Wrap the belt as many times around pillar as need so that when you step one leg inside each loop, the belt is around your upper calf and your toes are against the pillar. Squat back as deep as possible, keeping your spine upright. Don’t lean forward. Hold this position for 45 seconds; rest, then repeat.

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