BFR for Patellar Tendon Pain
BFR for Patellar Tendon Pain: Can It Help?
Patellar tendinitis can be challenging to manage, particularly when heavy resistance exercise aggravates symptoms. But could blood flow restriction (BFR) training offer an alternative?
Recent research suggests it may.
What does the research say?
A 2025 randomised clinical trial investigated low-load BFR training versus heavy slow resistance training in people with chronic patellar tendinopathy.
Both groups improved in pain and function following a 12-week rehabilitation programme, with no statistically significant differences between them.
The takeaway? BFR may be a useful alternative when heavy loading is difficult to tolerate, shown to be equally as effective. This is notable, as traditional heavy loading is very well documented as a remedy to improving tendon pain and function.
Can BFR improve tendon structure?
Research in healthy adults suggests BFR may influence tendon characteristics, including cross-sectional area and stiffness. However, findings are mixed, and evidence that BFR directly improves tendon structure remains limited.
It is also important to distinguish improvements in muscle strength and pain from actual changes in tendon tissue.
What does this mean for rehabilitation?
BFR could help athletes increase muscle strength using lower external loads while managing tendon-related symptoms.
However, it should complement an appropriately prescribed rehabilitation programme, not automatically replace progressive tendon loading.
Using our Hypertrophy & Strength Protocol would be perfect.. use one or two exercises to replace heavy loading or use as a strength “top-up” after a hard day or after a game/competition. Simply pick exercises that you or your athlete can tolerate, reduce the range too if needed.
Exercise Examples:
- Bodyweight squat/light goblet squat
- Bodyweight split squat
- Seated leg extension machine
- Regressed versions of knee dominant exercises in current programme
Conclusion…
BFR is a promising tool for tendon rehabilitation, particularly when heavy loading is poorly tolerated. Early evidence is encouraging, but more research is needed to establish its direct effects on tendon health, let’s see what research comes out next about this!
References:
- Hjortshøj, M.H. et al. (2025). Randomised clinical trial of low-load BFR versus heavy slow resistance training for patellar tendinopathy. Scandinavian Journal of Medicine & Science in Sports. https://doi.org/10.1111/sms.70186
- Öberg, S., von Schewelov, L. and Tengman, E. (2025). The impact of blood flow restriction training on tendon adaptation and tendon rehabilitation – a scoping review. https://doi.org/10.1186/s12891-025-08734-5