Heavy controlled loads of tendon with prolonged time under tension remain the treatment of choice in tendinopathy rehabilitation. The use of low-load resistance exercise (LL, 20%-40% 1-RM) in combination with blood flow restriction (BFR) has been advocated as a clinically important rehabilitation tool for persons not tolerating high muscle-tendon loads. Similar or improved clinical outcomes have been reported after LL-BFR compared to conventional rehabilitation following various types of knee injury, and also compared to load-matched, free-flow exercise. LL-BFR augments muscular adaptations and is comparably effective for inducing muscle hypertrophy and strength gains compared to heavy-load resistance training. The present study aimed to investigate the feasibility and effect of LL-BFR as a rehabilitation tool in individuals with chronic unilateral patellar tendinopathy. The results demonstrated that (a) 3 weeks LL-BFR was well tolerated with moderate-large pain improvements (Likert), (b) pain scoring (NRS) was reduced by 50% during single-leg decline squat testing, and (c) tendon vascularity diminished by 31% following 3 weeks (9 sessions) of LL-BFR. These novel data demonstrate substantial clinical and structural tendon improvements with short-term (3 weeks) LL-BFR, which warrant further research into the potential efficacy of LL-BFR as a clinical rehabilitation tool in patients with chronic tendinopathy.
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