Optimising Knee Health: Navigating Exercise and Tendon Care for Patellofemoral Arthritis

Miss Charlotte Barker
MSK Associate
Published at: 19/12/2023

Optimising Knee Health: Navigating Exercise and Tendon Care for Patellofemoral Arthritis


For those living with patellofemoral arthritis, exercise can be difficult to manage. While staying active is key to managing your condition, not all exercises are created equally. Understanding which movements can help and which may cause more harm is crucial. Here’s a guide to help you navigate your exercise routine effectively.

The Go-To Exercises for Patellofemoral Arthritis

  1. Walking: A simple yet effective low-impact exercise. Walking promotes joint health, improves circulation, and strengthens the muscles around your knees without excessive strain.

  2. Low Step-Up: This exercise targets your quadriceps and glutes, vital for knee support, while being gentle on the joints.

  3. 2-Leg Squat (to 60 Degrees): Squats strengthen your quadriceps, hamstrings and glutes. Limiting the squat to 60 degrees helps avoid putting too much pressure on the knee joint and patellar tendon.

  4. Low Step Down: A controlled step-down motion is excellent for building strength in a controlled manner, minimising the risk of knee pain.

  5. High Step Up: While more challenging, high step-ups build strength in your entire lower body, offering more stability to the knee joint.

Why These Exercises Work

These recommended exercises are low-impact and involve controlled movements, which are key for managing patellofemoral arthritis. They help in strengthening the muscles around your knee, ensuring better joint stability and alignment. This is essential as stronger muscles take some of the load off the knee joint, reducing pain and the risk of further damage.

Exercises to Avoid with Patellofemoral Arthritis

  1. 1-Leg Maximal Forward Hop: This high-impact exercise can jolt the knee joint, aggravating pain.

  2. 1-Leg Repeated Forward Hops: The repetitive, high-impact nature of this exercise can exacerbate knee joint inflammation.

  3. 1-Leg Countermovement Hop: Such dynamic movements can lead to misalignment and increased stress on the knee joint.

  4. Run-and-Cut: This involves sudden changes in direction, which can be harsh on the knees, especially for those with arthritis.

  5. 1-Leg Decline Squat: This exercise puts excessive load on the knee joint, which can be detrimental if you have patellofemoral arthritis.

Why to Avoid These Exercises

High-impact and dynamic exercises can significantly strain your knee joints. For those with patellofemoral arthritis, these types of movements can lead to increased pain, inflammation, and risk of injury. The key is to focus on exercises that build strength and flexibility without overloading the joint.

While exercising with patellofemoral arthritis, always listen to your body. If an exercise causes pain or discomfort, it’s important to stop and consult with a healthcare professional. Remember, the goal is to stay active and manage your symptoms, not to push through pain. Tailoring your exercise routine to your individual needs and abilities is the best approach to maintaining joint health and overall well-being.

Why is it important to reduce strain on the patellar tendon, for patients suffering with patellofemoral arthritis?

Reducing strain on the patellar tendon is beneficial for patients suffering from patellofemoral arthritis for several key reasons:

  1. Reduced Joint Stress: Patellofemoral arthritis involves the deterioration or damage of the cartilage under the kneecap (patella) where it articulates with the thigh bone (femur). By reducing strain on the patellar tendon, the direct pressure and stress on this already compromised joint surface are minimised. This is crucial because excessive stress can exacerbate cartilage wear and tear, leading to increased pain and further joint degeneration.

  2. Pain Relief: The patellar tendon plays a key role in the mechanics of the knee joint, including the distribution of forces around the knee. When there's less strain on this tendon, there's typically a corresponding decrease in knee pain, a common symptom of patellofemoral arthritis. This can improve the patient's quality of life and make it easier for them to engage in daily activities and exercise.

  3. Improved Function: By reducing the strain, patients may experience improved functional performance of the knee. It can enhance the ability to perform weight-bearing activities, such as walking or climbing stairs, with less discomfort.

  4. Prevention of Further Injury: Chronic strain on the patellar tendon, especially in the context of an arthritic joint, can increase the risk of other knee injuries, such as tendonitis or tendon tears. Reducing this strain helps in preventing such complications.

  5. Enhanced Rehabilitation Potential: Less strain on the patellar tendon can make physical therapy and rehabilitation exercises more tolerable and effective. It allows for a focus on strengthening and stabilising the knee joint without the interference of excessive pain or risk of aggravating the condition.

  6. Better Response to Treatment: Managing the strain on the patellar tendon can lead to a better overall response to various treatments for patellofemoral arthritis, including physical therapy, medication, and in some cases, surgical interventions.

In summary, reducing strain on the patellar tendon is a critical aspect of managing patellofemoral arthritis. It helps to alleviate pain, improve joint function, prevent further injury, and enhance the effectiveness of treatment modalities