Another BFR Success Story: Patellar Tendinopathy


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Another BFR Success Story: Patellar Tendinopathy

Nicholas M. Licameli, PT,DPT



Patellar tendinopathy is a common condition experienced by young athletes who participate in sports that involve jumping and running.Oftentimes, these patients are not able to tolerate the loading necessary to treat this condition due to pain, so BFR may be a tool to achieve similar physiological effects as heavy load training while using lighter loads.

In this case study, we are introduced to two NCAA Division III freshmen collegiate decathletes with a history of left knee pain prior to college and who had been complaining of increasing pain during the initial month of track practices.  Findings from their initial musculoskeletal examinations included left sided lower extremity weakness, pain during functional testing, pain when palpating the left patellar tendon, VISA-P scores less than 80, and thickened tendons on the left identified using ultrasound imaging at baseline.

Below is the 12-week BFR exercise protocol that was used.  A Delfi unit was used at 80% LOP with a set/rep scheme of 30/15/15/15 for the single-leg leg press and single-leg squat.

The results showed improvements in strength (both proximally and distally to the cuff), single-leg hop testing, single-leg squat testing, pain perception (VAS), and VISA-P score.  See below for details.


The authors concluded that, “The use of BFR may allow clinicians to prescribe exercises at a lower load, which may help decrease the chance of pain during exercise.  The authors continue by saying that the results, “showed mainly positive outcomes in the treatment of patellar tendinopathy,” but that “future research should compare the effectiveness of an exercise program for patellar tendinopathy in subjects with or without the use of BFR.”

What do you think?  Should BFR training be included in patellar tendinopathy rehabilitation across the board or is more research needed at this time?


Cuddeford, T., & Brumitt, J. (2020). In-Season Rehabilitation Program Using Blood Flow Restriction Therapy for Two Decathletes With Patellar Tendinopathy: A Case Report. International journal of sports physical therapy, 15(6), 1184–1195.

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****Remember, the use of BFR training should not be based solely on a success story.  The decision to use BFR, or any treatment for that matter, should be based on the pillars of evidence-based practice.


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