Chronic treatment

Topic Progress:

As with the treatment of acute injury, we recommend tendon-conditioning exercises before starting eccentric training. In chronic pathology we start directly with eccentric loading (as above). The eccentric exercises are progressed depending on the patient’s progress. We use a variety of different exercises.

Click on the following images to learn more about some of the treatments used at FC Barcelona to treat chronic tendinopathy.

  • Decline squat

    A single leg squat using a decline board can load the patella tendon

  • Isometric squat

    A more advanced isometric squat can provide good pain relief

  • Shock-wave therapy

    This can be used in the chronic phase to provide analgesia and stimulate healing

  • Transverse frictions

    A useful technique to 'warm-up' the tendon

Other treatments

There a variety of additional treatments that are used with these athletes. These involve the following:

  • partial weight-bearing exercise including the anti-gravity treadmill adjusted to the patient’s function;
  • electrotherapy following sports activity or post treatment;
  • shock wave therapy can be used in this phase;
  • cryotherapy three or four times a day and post sports activity.



We consider surgery when conservative treatments have not been effective for six months – or earlier if the symptoms are more severe. Currently minimally invasive, arthroscopically assisted, procedures seem to allow a faster return to sport (and are effective).21,22