Progressive loading programs and their effectiveness in patellar tendinopathy. A systematic review of the literature

Abstract

Introduction: Patellar tendinopathy is a common injury affecting the tendon that connects the patella to the tibia, characterized by pain in the anterior part of the knee, especially during activities involving jumping, running, or changes of direction. This systematic review aims to demonstrate the relevance of progressive loading programs in the lower body as an essential pillar in the management of this pathology, especially in at-risk populations such as athletes and physically active individuals. Materials and methods: This systematic review is observational, integrative, and retrospective, prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: Progressive loading exercises, particularly heavy slow resistance training (HSR) and eccentric exercises, have been shown to be the most effective in reducing pain and improving function in patients with patellar tendinopathy, promoting remodeling and reducing tendon stiffness, increasing load-bearing capacity. Discussion: Progressive loading programs are an essential pillar in the physiotherapy and sports treatment of patellar tendinopathy. Combining exercises with patient education and professional supervision improves adherence and outcomes. Conclusions: Furthermore, they suggest that addressing closed kinetic chain exercises such as squats and heavy slow strength training (HSR) can optimize recovery and prevent relapse, which is crucial in sports.