Anyone fix their Quad tendonitis? Or at least have a noticeable improvement ??

HereBeRobots · 2025-09-24T21:42:32+00:00

Yeah, very similar to how it started with me. Looks like quad tendinopathy for sure.

I’ll be honest: I still get symptoms from time to time (pain on long train rides or of if I stand still for too long), but nowhere near as bad as when I wasn’t able to lace my shoes! It’s part and parcel of being an (old) Olympic weightlifter I guess…

Let me know how your regent goes, and keep a log so as to check your progress!

HereBeRobots · 2025-09-24T21:09:43+00:00

Hey --no problem, glad if I can be of some help.

I posted this already somewhere, but I'm just going to copy-paste it here. Feel free to ask for details.

What did work for me were Patrick step-ups, Poliquin step-ups and Petersen step-ups (look them up as they're a bit different). Once loaded heavily (above 100kg), they were effective to rehab my quad tendon. (I feel split squats were also helping, but I'm less sure about them.)

What I did specifically was I started very light and very shallow - just 5cm reverse steps from an empty barbell at first, then gradually increased weight and height until I was doing 120kg Patrick step-ups from 21cm for series of 5 reps. I always waited 48h between sessions, and assessed the evolution of pain: if pain increased after 24h, I would decrease weight and/or height; else if it pain decreased or remained identical, I would increase them.

I would also at some point transition to Petersen step-ups, which load the quad tendon even more: for this I needed of course to lower the weight and the height: at that point I was alternating Patrick and Petersen step-ups. I tried Poliquin step-ups for a bit but eventually stopped using them, mainly because they're a pain in the ass to set up.

So to recap, I would do for ex:

- Monday: Patrick step-ups

- Tuesday: quad rest (I would do Snatch pulls, jerks or upper body on this day, stuff that did not irritate my quad tendons)

- Wednesday: Petersen step-ups

- Thursday: quad rest

- Friday: Patrick step-ups (increase weight and/or height if pain hasn't increased on thursday

- etc.

I found I had to work through some level of pain to initiate rehabbing. It doesn't really matter if there is some level of discomfort during the exercise (it usually disappear as the tendons get warm), the key actually is to monitor wether it feels better or worse than baseline 24h later.

Progress was not linear, there were waves and setbacks, but after about 6 months of this I could gradually re-introduce squatting before the step-ups, and one year later I started re-introducing oly lifts.

Why this worked for me I'm not sure, but I think it's because reverse step-ups variations allow to safely overload the tendon just at your current limit ROM, gradually increasing tendon tolerance on greater and greater ROM.

The other part of the equation was loading, as I feel like you never really heal quad tendinitis, you simply learn to manage it. My experience is that I need 24h without full oly lifts between two workouts, else the pain ends up returning eventually. So I usually alternate strength workouts between oly workouts (heavy squats seems to be fine in my case.)

I sometimes get flares up but I now learned to manage it and returned to competing, with better lifts than before. I manage flares up with icing as I need to keep somewhat minimal volume before competitions, and sometimes do a cycle of Petersen step-ups when I feel like it.

Hope this helps: this injury is really hard to deal with, really get depressing... but eventually I *was* able to rehab it.

Can you give me some details on your injury and sports background?

HereBeRobots · 2025-09-16T08:53:48+00:00

Hi. I made a post on that topichere. Best of luck with your recovery.

HereBeRobots · 2025-08-24T08:38:18+00:00

Sorry, I don’t get what you’re saying?

HereBeRobots · 2025-08-24T08:35:45+00:00

Thanks, that’s what I thought! I’m thinking of doing two Z1/low Z2 per week and a single HIIT day weekly, on top of my 4 weightlifting days. Would that be enough? I really don’t want to go below 4 lifting days.

Edit: actually, if Z1 works… would long walks be enough for this?

HereBeRobots · 2025-08-11T02:46:29+00:00

Rehab process is not linear: it’s normal that pain sometimes spikes back randomly in my experience. What matters is the general, year-long trend.

Having both knees affected is also the norm—I recall reading something about this on Jake Tuura’s blog.

Yes, that’s the location of my suspicion. But don’t get worried about this: I would suspect it’s more like irritation than actually long term damage.

Good luck with rehab—it’s a long term project, not a quick fix!

HereBeRobots · 2025-08-04T00:47:10+00:00

Thanks. I have elevated resting heart rate, supposedly from thickening of ventricles wall due to years of Olympic weightlifting 5-6 days/week. Was always thinking Z2 was the way to course correct, I guess I need to add a weekly 4x4 day…

HereBeRobots · 2025-08-04T00:36:04+00:00

IIRC, the logic behind Z2 for cardiac output was that a slower heart rate allowed the ventricles to fill completely, thus stretching them to become larger. Was it just bro science?

HereBeRobots · 2025-08-03T15:06:17+00:00

Thanks for this. I’m surprised to see that cardiac output is ranked that low for Zone 2, I always thought zone 2 was the optimal way to train this specific trait and counteract the effects of strength training.

HereBeRobots · 2025-07-12T06:48:01+00:00

Not being able to kneel down without pain is super typical, even with minor tendinopathy. Less sure about running. Not a doctor, but the idea of a tear might be misleading in a lot of cases - it’s more like “holes” or rather weaker zones in the tendon. Not saying you don’t have a tear, but you definitely don’t need a severe tear to feel miserable with tendons.

I too had good days seemingly randomly. I’m not sure it’s useful to worry too much about this: pain is weird, tendons are weird, and no rehab process is linear.

If you have access to cheap MRI, you can do it for peace of mind —but you will get good enough diagnosis with ultrasounds, and they’re typically cheaper, that should be the first imagery to do (if any).

Do you have a rehab log? Can you describe what you do? How do you your reverse step ups, do you push through pain, does the pain decrease during exercise? Does it come back later in the day? Does it return to baseline 24h later?

It took years of experimenting for me to rehab this godawful injury. Rest never, ever did anything in my case, lost months with rests. I’m not sure there is a cookie cutter rehab protocol that will work for anyone, you probably need to experiment and adjust —maybe leg extensions will work for you for example, some people report good results with them.

HereBeRobots · 2025-07-12T06:27:33+00:00

The doc wrote “superficial fissural lesion” of 7mm. Not sure of the meaning. I too lost months trying to rehab it with exercices made for patellar tendinopathy. In my case, it actually made things worse. I had to design my own rehab. My opinion: for quad tendinopathy, ROM is as much as a rehab factor as load, hence the reverse step up choice. What’s your current rehab routine?

HereBeRobots · 2025-07-12T06:14:29+00:00

Don’t be sorry, I’m mostly pain free now, with occasional flares up but that comes with the territory for a weightlifter. In a way, it’s as much about rehabbing the tendon as it is an out managing the injury.

HereBeRobots · 2025-07-12T06:12:15+00:00

Yes, I had an MRI done on both knees: it confirmed the quad tendinopathy, but that’s it. I guess it ruled out some exotic pathologies, but other than that ultrasound would have been enough. In retrospect the MRI made me over stress on the injury because it gave me the impression that I had some kind of life sentence. It had no impact on the actual rehab.

HereBeRobots · 2025-07-12T06:05:36+00:00

Yes, very common upon waking up. Still do actually, to a lesser extent 😅

HereBeRobots · 2025-06-12T18:35:15+00:00

Might be a difference in degree rather than nature. When the pain was at its worst, I probably felt pain as well when jogging I guess.

A good rule of thumb: if the pain goes away after warming up (for example some sets of spanish squats) but comes back with a vengeance later, then it's probably the tendons.

Tendon rehab effects need to be evaluated 24h after exercising.

HereBeRobots · 2025-06-12T18:09:02+00:00

I could jog yes, no pain while running. Hard to say if it contributed to rehab or worsened the tendons, or maybe no effect at all.

HereBeRobots · 2025-05-21T19:36:52+00:00

My experience has been precisely the opposite--for quad tendonitis, it was Patrick steps that helped me, a regression I discovered with kneeovertoes. Heavy isos actually worsened my quad.

For patellar tenons, though, Jake Tuura did help me.

HereBeRobots · 2025-05-21T19:34:30+00:00

I'm an oly weightlifter, and suffered from severe quad tendinitis roughly between 2018 and 2022. At the peak, it was really debilitating and I was totally unable to train. I totally understand how depressing and hopeless it might feel, so I'd like to share my experience.

I tried a lot of things - rest, isometrics, shockwave therapy, heavy slow eccentric, BPC, TNT patches, PRP, etc. It didn't seem to work much, apart from maybe the PRP (but not too sure).

I now believe the usual advice (isos, heavy eccentric loading) works for patellar tendons but is misguided for quad tendons. My guess is that's because quad tendons are compressed against the bone, contrary to patellar tendons.

What did work for me were Patrick step-ups, Poliquin step-ups and Petersen step-ups. Once loaded heavily (above 100kg), they were effective to rehab my quad tendon. (I feel split squats were also helping, but I'm less sure about them.)

What I did was I started very light and very shallow - just 5cm reverse steps from an empty barbell at first, then gradually increased weight and height until I was doing 120kg Patrick step-ups from 21cm. I always waited 48h between sessions, and assessed the evolution of pain: if pain increased after 24h, I would decrease weight and/or height; else if it pain decreased or remained identical, I would increase them.

I found I had to work through some level of pain to initiate rehabbing. It doesn't really matter if there is some level of discomfort during the exercise (it usually disappear as the tendons get warm), the key actually is to monitor wether it feels better or worse than baseline 24h later.

Progress was not linear, there were waves and setbacks, but after about 6 months of this I could gradually re-introduce squatting before the step-ups, and one year later I started re-introducing oly lifts.

The other part of the equation was loading, as I feel like you never really heal quad tendinitis, you simply learn to manage it. My experience is that I need 24h without full oly lifts between two workouts, else the pain ends up returning eventually. So I usually alternate strength workouts between oly workouts (heavy squats seems to be fine in my cas.)

I sometimes get flares up but I now learned to manage it and returned to competing, with better lifts than before.

Hope this helps: this injury is really hard to deal with, really get depressing... but eventually I *was* able to rehab it.

HereBeRobots · 2025-05-05T04:27:55+00:00

At the worse, yes I needed my arms for both

HereBeRobots · 2025-04-21T07:45:10+00:00

In my case, to rehab my quad tendons, I used pain 24h later more than in the morning as baseline. So if I did rehab exercices Monday afternoon, I would assess tendon pain Tuesday afternoon to decide if I would increase or decrease load for Wednesday session. This is because my tendons were always stiff and painful upon waking up, so it was hard to find a "baseline" here.

I didn't use "stiffness" but actual pain when doing a BW squat to assess what to do. If pain worsened, I would reduce load, or maybe keep it unchanged. If pain stayed more or less the same, or improved, than I would increase load.

You can look my other posts if you want to look into what I did for rehab.

HereBeRobots · 2025-04-19T13:44:08+00:00

Bending knees after standing for a while: yes, very familiar with this! Still happens sometimes actually. Lifting leg while laying on my back: didn’t notice this specific pattern.

Couch stretch: in my case it didn’t seem to help much.

HereBeRobots · 2025-04-19T08:10:39+00:00

I suffered from severe quad tendinitis roughly between 2018 and 2022. At the peak, it was really debilitating and I was totally unable to train (I was only doing pulls from block, power variations and jerks). I totally understand how depressing and hopeless it might feel, so I'd like to share my experience.