Therapeutic exercise
Decline Eccentric Squat
Unilateral squat with the heels on a declined surface (25-degree decline board), focused on the eccentric phase. Protocol by Purdam and Cook for patellar tendinopathy — the decline increases load on the patellar tendon during the descent phase.
How to perform
- Starting position. Position a board with a 20 to 25-degree decline, or rest only the heels on an object that elevates the front of the foot (firm books, wooden board).
- Step 2. Step onto the board with both feet, heels supported and toes pointing downward.
- Step 3. Transfer weight to the affected leg, lifting the other leg off the support.
- Step 4. Slowly descend into a unilateral squat over 3 to 4 seconds (eccentric phase) to about 60 degrees of knee flexion.
- Return. Use the contralateral (unaffected) leg to return to the starting position — skip the concentric phase. Repeat only the descent.
When not to perform
- Patellar tendinopathy in acute reactive phase (start with isometric first)
- Partial or complete patellar tendon rupture
- Severe patellar chondromalacia
- Patellar instability
- Recent post-operative knee surgery
- Pain that does not subside within 24 hours after the exercise
Medical disclaimer. These exercises are presented for informational purposes only. Always consult your physician before starting any exercise program, especially in case of acute pain, recent injury, or underlying clinical condition.
Related Exercises
Spanish Squat Isometric
Partial isometric squat with the hip supported by an elastic band anchored behind. Protocol by Rio and colleagues for patellar tendinopathy — produces immediate analgesic effect on the patellar tendon without aggravating the reactive condition.
Wall Sit
Isometric quadriceps strengthening in a closed kinetic chain. Provides controlled axial load while respecting the pain threshold in osteoarthritis.
Standing Quadriceps Stretch
Stretches the quadriceps and rectus femoris, frequently shortened in patients with chondromalacia. Reduces traction on the patella.