Patellar tendinopathy, aka jumper’s knee, is common in athletes, especially older athletes and those that play sports that involve a significant amount of jumping. Badminton, although often seen as a “backyard sport,” causes a lot of stress on the knees through quick and explosive movements when played at a higher level. It can often be a crucial point in one’s athletic career to step out of their sport and fix this injury, as it can be very detrimental to your ability in the future.
This knee pain happens because athletes put too much stress on their knees, which results in tiny tears in the patella tendon (what attaches your kneecap to your tibia). These tiny tears often accumulate because people tend to push through the pain resulting in constant knee pain when playing sports.
I’ve had knee pain for the past year, but my knee pain has gradually improved after doing these exercises and following these procedures. In this patellar tendinopathy treatment for badminton athletes article, I’ll identify what exactly causes this knee pain, how to fix this knee pain, and how to prevent future patellar tendinopathy cases.
Identifying Patella Tendinopathy Symptoms
The first step is to identify the injury. But before we dive into it, I would like to make the full disclaimer that this article is not legal medical advice and cannot be used to replace medical advice from professionals.
There are plenty of different types of knee pain, but some of the main indicators of patellar tendinopathy are listed here:
- Pain is around the bottom of the kneecap
- Pain gets better when you begin to “warm up”
Additionally, here is a video I personally found helpful for identifying patellar tendinopathy:
Identify What Activities Cause Knee Pain
The second step is to identify when you’re getting this knee pain. A good and effective way to identify knee pain is to record your pain the day after you did a certain activity using a test exercise (single-legged squat). For example, if I played badminton for 2 hours, I would measure my pain the next day by doing a one-legged squat for each leg and record my pain in a journal on a scale of 1-10. If you’re coming to this article, it is most likely from badminton, but here are some other causes it could be from:
- Being overweight (puts more pressure on the knees)
- Playing other sports
- Previous injuries
You must be extremely careful if you have a previous injury when returning to sport. When coming from a previous injury, people tend to rest for a few months at a time, and during that time, your patella tendon becomes adapted to this activity level. Then they jump right back into the intensity they were playing at prior to the injury and knee pain often occurs.
Once you have identified the cause of this knee pain, you must immediately stop the activity or lower the intensity of the activity depending on how bad your knee pain is.
The 4 Stage Patellar Tendinopathy Treatment Process
The 4 Stage Patellar Tendinopathy Treatment Process is exactly what it sounds like. It consists of 4 stages in which the athlete undergoes to GRADUALLY ease their knees back into playing their sport. Before we get into it, one thing to note is that you must record your pain the following day after EVERY SINGLE workout in ALL stages.
First Stage: Isometrics
For those who don’t know what isometrics are, they are essentially muscle contractions without movement. Isometrics are extremely beneficial to the health of your knees as they strengthen the muscles around the tendon and carefully load the injured part of the tendon. They are essentially the foundation of the 4 Stage Rehab Process.
There are an infinite number of isometrics that you can perform if you would like to better your knee health, but through my experience, I found three exercises that would consistently perform and give me the best results. Here are the exercises I performed.
Leg Extension (Kettlebell/Machine):
The leg extension is a wonderful exercise for curing knee pain as it isolates the knee joint and targets the quadriceps, the main muscle group that supports the knee joint. It requires a leg extension machine or a kettlebell. I recommend training each leg independently to avoid muscle imbalances. (Link amazon kettlebell options?).
Example exercise:
5 sets of 45s on each leg. After each set, you increase the weight.
- First set of 45s at 45lbs
- Second set of 45s at 60lbs
- Third set of 45s at 75lbs
- Fourth set of 45s at 90lbs
- Fifth set of 45s at 105lbs
Leg Press (Machine):
The leg press is also a great exercise for knee pain because it strengthens the quadriceps and the glutes. I also recommend training each leg independently on this exercise to avoid muscle imbalances.
Example exercise:
5 sets of 45s on each leg. After each set, you increase the weight.
- First set of 45s at 45lbs
- Second set of 45s at 60lbs
- Third set of 45s at 75lbs
- Fourth set of 45s at 90lbs
- Fifth set of 45s at 105lbs
Wall Sit (No equipment needed):
Wall sits are the exercise I started off with. They are exceptionally easy to perform. All you have to do is lean against the wall and lower yourself until your knees are 90° against the wall.M ake sure to keep your shoulder blades always touching the wall. This is a great option because not everybody has access to a gym.
This exercise can be easily scaled by adding weights in any form. You can hold jugs full of water, dumbbells, or even boxes on your legs to increase the difficulty of this exercise.
Example exercise:
3 sets to failure
- First set failed at 2 minutes
- Second set failed at 1 minute 30 seconds
- Third set failed at 1 minute
NOTE: Remember, when performing these exercises, you should always aim to push yourself to muscular failure so your tendon gets the most adaptation possible. Pain during exercise is negligible unless it is excruciating. The only pain that matters is if your knee feels better or worse the next day.
Second Stage: Isotonic Exercises
After you performed the isometrics for at least a week and score pain levels below three the whole week, then they are safe to move on to the next stage: isotonic exercises. Contrary to isometric exercises, isotonic exercises are muscle contractions over a range of motion.
Many people who suffer from knee pain never get it fixed because they skip this stage. They feel their knees feel better after the isometric stage and assume they are ready to go back into sport. This mistake is fatal as it often pushes people further back into rehab, taking a longer amount of time to fix their knees.
The exercises should be alternated day by day. This means that the first day should be isometrics, second isotonic, third isometric, etc. Again, there are an infinite number of exercises that you can do, but here are some exercises that I personally found helpful.
Bulgarian Split Squat
The Bulgarian split squat is an exercise that is extremely effective at fixing the knees because it applies stress to the knees, which allows the patella tendon to adapt. It also strengthens supporting muscles like the quadriceps and glutes. When doing this exercise, you can’t pause at the top of the rep for too long as it takes away the load on the injured area.
- 4 sets of 12 each leg
Squats (Can do heel-elevated squats)
Squats are less effective than Bulgarian split squats, but they strengthen the glutes, which is often a weak point, especially in badminton players. Heel-elevated squats isolate the knee joint and work the quads more than if you were to do flat-footed squats. You can do heel elevated squats with a slant board or simply a 45-pound plate under the heels of your feet.
- 4 sets of 12
Standing Calve Raises
Calves are an extremely important muscle group in solving knee pain as they are the muscles that absorb the impact first. The calves are also important in badminton as they determine a lot of a player’s explosiveness when reaching for shuttles. When I work calves, I usually do standing calve raises to failure.
- 1 set to failure
Sitting Calve Raise (works the soleus)
Similar to the standing calve raise, the sitting calve raise also works on the calves but specifically targets the soleus, the lower portion of the calve muscle. To do this exercise, I sit on a bench and place a dumbbell on the leg that I will be working. Then I simply perform a calve raise from there.
- 4 sets of 15
Hip Adductor Exercises
The hip adductor is a very underrated muscle and is often neglected. However, I believe it is very important to train this muscle, especially if you want to fix knee pain and improve your split step in badminton. This exercise can be done with a resistance bands.
Hamstring exercises
Hamstring exercises are important because it is important to train the antagonistic muscle of the quadriceps. This prevents you from having alignment issues that support your tendons and joints.
4 sets of 8-10 hamstring curls
4 sets of 8 Romanian deadlifts (can also do 4 sets of 8 single-legged Romanian deadlifts)
The isotonic stage follows the same rule; once the athlete has participated in at least a week of isotonic exercises and their pain level is below 3/10 every day, then they are allowed to move to the next stage.
Third Stage: Store & Release Exercises
After completing the first and second stages, this stage now brings in more explosive movements, like squat jumps. With the addition of isometrics and isotonic exercises, your workout schedule should look something like this:
- Day 1: Isometrics
- Day 2: Isotonic
- Day 3: Store & Release
- Day 4: Rest
- Day 5: Isometrics
- Day 6: Isotonics
- Day 7: Store & Release
Now that you know what the workout routine should look like, let us explore some of the options available for the third stage of the rehab process.
Running With Direction Change
This exercise aims to target your agility and knee pain when changing directions. You can do this over 40m with three cones in between and enough space to get up to a moderate pace between the cones. When you reach a cone, you want to change directions slowly/quickly depending on your knee health. As your knee becomes stronger and stronger, you can gradually build up the intensity of the drill.
- 6 sets of running through the cones. Increase the intensity a little with each set.
Practice Landing
Practicing landing is less stressful on the knees than actually jumping. Instead of jumping, you will drop down from various heights depending on how your knees feel and practice landing. And depending on the knee pain you get the next day, you can scale the height accordingly.
- 3 sets of 12 landing practice
Squat Jumps
Squat jumps are extremely generic exercises when it comes to plyometrics. This exercise is great for increasing your vertical jump and improving cardio. However, it might prove difficult for an injured athlete to immediately jump into this exercise after completing stage 2 of the patellar tendinopathy treatment process, so exercise caution and pay attention to your knee pain!
You can also scale the intensity of this exercise with lower/higher jumps. Here are the sets and reps:
- 4 sets of 15 squat jumps
Tuck Jumps
Tuck jumps are pretty much the same as squat jumps. The difference is your body is given time to absorb the force with a squat in a squat jump so tuck jumps might be more difficult on the knees. I recommend performing this exercise after scoring 3/10 pain level in the knees on the squat jump for a week. Here are the reps and sets:
- 4 sets of 15 tuck jumps
Fourth Stage: Return to Sport!
In this stage, you should return to sport very gradually. How I would recommend doing this specifically for badminton is starting slower on the footwork and gradually ease in as I warm up. You might need to return to the previous stage if your pain level in your knees rises above 3/10 the next day.
I would let your coach know about your knee pain and the steps you are taking to resolve the issue so you two can work together to avoid further injuries.
Other Patellar Tendinopathy Treatment Methods
A knee brace temporarily relieves knee injuries, meaning it won’t fix your knee pain. Knee braces may also be detrimental to your overall knee health if used too much, so I would only recommend using a knee brace for temporary relief in situations such as playing tournaments.
Here are a couple knee braces you can buy from Amazon:
I’m a big fan of the knee straps that solely target the patella area, but bigger braces help as well. It does take a little bit of testing with different products to see what works better.
I also highly recommend seeing a physiotherapist or other specialty doctors for patellar tendinopathy treatment advice. Remember, every person’s body is unique from one another. The training strategies described in this article may not work for everyone and thus, it is important to learn more about what you personally can do.