This is a nice randomised trial showing the importance of load as a therapeutic tool in tendinopathy. Adequately managing load through the stages of treatment (including load during treatment but also of sporting/ leisure/ work activities) is increasingly being found as the most important factor in conservative tendinopathy management, especially in chronic cases.
Here we see that a multi-stage programme from isometric to explosive exercises led to improved results at 6 months. Nevertheless, the low adherence seen in both groups is a matter of concern, as the results may have been more pronounced if this value was higher. Actually performing the prescribed exercises is a massive issue in daily practice, and clinicians still need to find strategies to ensure this.
Patients in this study had both a clinical and ultrasound diagnosis of patellar tendinopathy. Having the clinical diagnosis is crucial, since tendon imaging findings have shown high variability even in asymptomatic individuals (see for example this study). For further details on outcomes and on the exercise programmes used on the summarised study, a link to the free full text version can be found above.