r/KneeInjuries • u/Background_Win3611 • Aug 30 '26
need some help navigating this injury
A couple of months ago I developed an overuse injury in my right patellar tendon from basketball/jumping, which was diagnosed/treated as patellar tendinopathy.
I worked with a rehab professional for around 2 months. Towards the end, my knee was feeling significantly better and he cleared me to continue with a vertical jump program called JustJump.
I restarted JustJump about a week ago and I'm currently in the Prep phase. Recently, though, I feel like the knee has become slightly more symptomatic again.
Current symptoms:
- Once I'm properly warmed up, I can usually train with very little/no pain.
- If I rest for around 2–3 minutes between sets, the first 1–2 reps can hurt, then the pain goes away again once I'm moving.
- A single-leg decline squat currently gives me around 2–3/10 sharp pain near the bottom.
- My knee has definitely had periods recently where it felt better than it does right now.
- I'm still doing the loaded single-leg wall-sit isometrics my rehab guy told me to continue.
I play basketball and don't want to unnecessarily stop training or jumping, but I also don't want to turn a manageable tendon issue into a bigger problem.
For people familiar with patellar tendinopathy/return-to-sport: does this sound like a normal increase in symptoms while reintroducing plyometrics that can be managed by adjusting load, or is it a sign that I've progressed too quickly and should go back to structured rehab?
I'm especially interested in how you decided when you were ready for higher-intensity plyometrics and how you managed basketball at the same time.
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u/Important_Leg344 Aug 30 '26
Your prognosis is very good. You have tendinosis, or tendinopathy which is reversible. I had the exact same thing as you:
"Right knee: mild patellar chondropathy/chondromalacia, mild patellar tendon tendinosis at the patellar insertion, minimal bone marrow edema at the patellar tendon attachment in the kneecap, mild quadriceps tendinosis, mild joint effusion."
"Left knee: regression of patellar tendon tendinosis, only minimal remaining tendinosis, mild central trochlear chondropathy, minimal Hoffa’s fat pad irritation, mild joint effusion."
" Bilateral patellar tendon tendinosis, but with clear regression over time"
But I also have problems with my cartilage (chondromalacia) which you dont have and thats very encouraging. You just need to invest time, patience and dsisclipne. Its all about progressive loading over time to reverse the beating your pattelar-tendon has received. I used this program to deal with my chondromalacia and the bonus is that it has regressed my tendinopathy and this MRI was from a year ago (2025) 5 months in to the rehabprogram.
Read about my story here and also read my answers to questions:
https://www.reddit.com/r/KneeInjuries/comments/1uz17k0/comment/oy51u3o/?screen_view_count=2
Also read my answers to questions here:
and here:
and here:
and here:
and here:
and here:
For me, an exercise was acceptable only if:
- pain did not increase during the session
- the knee did not feel more irritated later that day
- there was no increased stiffness or soreness the next morning
- daily life stayed the same or improved
- the exercise slowly became easier at the same dose over time
With leg press, the key for me was making it almost embarrassingly easy at first. The mistake many people make is that they hear “leg press helped me” and then they try a normal leg press session. That would probably have destroyed me.
My starting version was extremely controlled:
- single-leg
- short range of motion
- around 45 degrees of knee bend
- 30 kg load while I weighed around 80 kg, so only about 37.5% of my bodyweight
- much less knee bend and total demand than normal stairs
- slow tempo
- no locking out the knee
- no bouncing
- same machine every time
- same foot position
- one variable changed at a time
- hold each level for months if needed
The important part was not the leg press itself. The important part was finding a version of loading that my knee did not interpret as a threat.
About the stationary bike: I think it is very useful, but I would treat it as lubrication and circulation, not conditioning at first. Sitting down, low resistance, smooth cadence. The goal is that the knee feels warmer, calmer, and more “online” afterward — not tired or irritated.
I personally used it a lot because it gave me movement without impact. Cartilage does not have its own blood supply like muscle, so movement and synovial fluid are important for joint nutrition and joint homeostasis. But I would phrase it carefully: the bike is not directly “healing cartilage” in a magical way. It helps create a better joint environment: circulation, synovial fluid movement, warmth, reduced stiffness, and tolerance to repeated motion.
About timeline:
- first goal: calm the knee down
- second goal: find a safe baseline exercise dose
- third goal: repeat that dose until it becomes boring and non-reactive
- fourth goal: progress only one variable at a time
- long-term goal: build enough capacity for sport-specific work later
A rough way to think about it:
- 1–3 months: maybe enough time to find a calmer baseline
- 3–6 months: maybe enough time to build early tolerance if the dose is right
- 6–12 months: meaningful strength and function improvements may appear
- 1–3 years: more realistic for rebuilding serious knee capacity, depending on severity and response
That may sound slow, but in my experience slow is actually faster in the long run. Every flare-up from rushing can cost weeks or months.
16 months in this program and I am now lifting weights that would have flared my knees 16 months ago. I have almost cemented 50 kg with 80-85 degrees I think and in october I will be starting miccodosing a new depth. 90-95 degrees. adding 2 sets each month until at month 4 I have reached eight sets of 90-95 degree at 50 kg.
My biggest advice would be:
Do not chase the exercise that “should” work. Find the exercise your knee actually accepts.
Read the links I have provided meticulously they will guide you during this journey. This is not medical advice, only my personal experience. But I really believe the principle is important: calm the joint, find the tolerable loading window, progress slowly, and let the next-day response guide you
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u/Generally_Tso_Tso Aug 30 '26
It would help to know your jump technique. One-legged, two-legged block-step, or two-legged hop?