Quad tendinopathy - Unsure how to transition to barbell and progress

Pain & Rehab Forum [Moderated]
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Hi, recently just got to know about Barbell Medicine. I had a question regarding rehab for quad tendinopathy. I’ve been having right knee tendinopathy for almost a year now and I’ve started implementing high rep hindu squats which has been helping me and reduced pain. However, I am unsure on how to transition back to barbell squats and make progress without jeopardizing recovery of the tendon. I’ve gone through the article on tendinopathy and have begun to implement the protocols listed, so I wanted to know whether I should keep doing light-moderate weight high rep front squats/ high bar back squats or should I use a box squat or pin squat instead? Any advice would be greatly appreciated!

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Hi @Ishan1508 ,

Thanks for the question and I’m glad to hear the high rep tempo squats have been helping out thus far. If you’re currently able to perform high rep/tempo squats with full range of motion in the 8-10 rep range without a significant increase in symptoms, I would recommend sticking with full range of motion moving forward. In regard to the rep scheme, you could ‘stair-step’ the rep range down every 2-3 weeks to gradually increase loading and progress back to ‘normal’ training, whatever that means for you.Here is an example:[/FONT]

  1. Weeks 1 & 2: 3.1.0 (3s on the way down, 1s pause in the hole) Back Squat (full ROM): 10 reps at RPE 6, 10 reps at RPE 7, 10 reps at RPE 8
  2. Week 3 - 8 reps at RPE 5,6,7
  3. Week 4 - 8 reps at RPE 6,7,8
  4. Week 5 - 6 reps at RPE 5,6,7
  5. Week 6 - 6 reps at RPE 6,7,8
  6. Week 7 - 5 reps at RPE 5,6,7
  7. Week 8 - 5 reps at RPE 6,7,8
  8. Week 9 - 5 reps at RPE 6,7,8 (Normal tempo)
  9. Week 10 - transition back to your ‘normal’ training I would also include some unilateral work in the mix (split squat variations, single leg leg press, single leg leg extension, etc.) on the back end to address any side to side differences between your left and right side.

Keep in mind that these recommendations do not need to be set in stone and there are numerous ways you can go about this process. These suggestions should get you moving in the right direction, but feel free to modify and make adjustments as you see fit. The overarching concept is to gradually progress load/volume, assess your response, and then make adjustments accordingly over time as outlined here.

Hope that helps,
Charlie

1 Like
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Thank you so much for the advice!! I’ll be implementing your suggestions into my routine. In case symptoms do flare up in the future, would it wise to regress to a movement with partial range of motion or to cut back on weight and continue full range of motion?

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I would start with reducing load at full range of motion and building back up from there. If you have to drop load a significant amount (let’s say more than 25% at full range of motion) for symptoms to stay tolerable, then maybe try working up to a top set with partial range of motion followed by a 20-25% load drop at full range of motion.

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Got it, thank you so much :slight_smile: