The Secret to the Eccentric Exercise Protocol

After reading medical journal articles on the use of eccentric exercise to treat patellar tendinopathy, I set out on my own to do the exercises. Unfortunately, it took me 1-2 years of trial-and-error experimenting to figure out a proper protocol.

While eccentric exercises helped to significantly reduce my knee pain, my early trials led to relapses and increased pain. In retrospect, I figured out what I was doing wrong. I had added too much weight to the backpack too quickly.

I found that for the exercises to be successful, weights need to be added SLOWLY over MONTHS. Furthermore, for the first 1 to 2 months I didn't use any weights at all. Then I started with 1/2 pound weight in the backpack. After 4 days, I added another 1/2 pound, and so on.

The reason to wait four days is to see if there is increased daily pain. It sometimes takes several days for increased activity to manifest itself in pain. You don't want pain to increase over those four days. After 4 days, and assuming my pain did not increase, I would add another 1/2 pound weight.

If my pain ever increased, I'd take off a day or more from the eccentric exercises.

So, the secret I discovered is to add weights S-L-O-W-L-Y over time.

Some of the research I read suggested patients add weights until they got to 20 pounds or so in the backpack.

Assuming one adds 1/2 pound every 4 days, and assuming one takes a rest day after every 8 days of the exercise, one will be adding 1 pound every 9 days. So, to get to 20 pounds will require 9 x 20 = 180 days, or 6 months. This doesn't include a period of 1 to 2 months with no weights at the beginning of the protocol.

A number of the research studies in medical journals used a 12-week program. This may work for some people, but there may be others where a much longer time period is needed. I believe I am one of those people.

Eccentric exercise requires many months of dedication. But, I found that it is well worth it after several years of pain.