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Patellar Tendon Issues. Zercher, Front or Safety Bar Box Squats?

I’ve been dealing with patellar quad/knee tendon that comes and goes. I’m doing a 5/3/1, but since i wanna fix this for now and forever. I’m juggling with a rehab plan.

I’m following Squat University’s “FIXING PATELLAR & QUAD TENDON PAIN” plan as precise as i can.

I switched to Box Squats for my Main lift (not doing 5/3/1). And here comes the Issue.

Since box squatting puts more stress on my low back, i find it extremly hard to get a good amount of effective weight to really build my load tolerance up (for my knee).

I searched for some solutions and i have like 4 options left i guess.

  1. Keep doing with low weight to strenghten low back until the back stress decreases? (i think this is the dumbest solution).

  2. Switching to Zercher Box Squats. Found the article “The Smartest Way To Squat To Save Your Spine” by Alex Nurse.

  3. Front Box Squats. Maybe to much stress on knees?

  4. Safety Bar Box Squat, and this is kinda a guess. If this is correct; the heavier the load is, the more difficult it could be to handle with zercher squats. So switching to a safety bar could help. BUT i never tried a Safety Bar before and i’m not that sure if the core activation and less low back stress is similar/same with zerchers.
    I tried Zerchers and my low back feels super fine.

I don’t have access to a Safety Bar cause i train at home. Is it worth trying out/buying one?

I keep doing Zerchers til i can’t handle the weight anymore.

Anyone dealt with patellar tendon, and did a comeback?

Tbh, I wouldn’t consider any of those useful changes to address patellar tendinopathy. To address PT, you need to primarily load the knee extensors / quads in deep knee flexion. The problem is any style of box squat will bias loading to the hips (assuming you’re performing them Westside style) and get you no deeper than ~100° knee bend max.

What 531 template are you doing? What I would do is do my main work as a standard box squat, and my supplemental work as no-box zercher or front squats, with a heel elevation, upright torso, maximum knee-over-toe motion and maximum depth. This is to really load the shit out of the quads.

How frequently and with what sort of load and duration are you doing your isometrics?

I ran into the same issue (quad tendonitis) a few years ago and switched to SSB box squats. The pain was gone almost immediately. I actually found that I prefer box squats (SSB and barbell front squats) and have been doing them ever since. (I sometimes do Zerchers as well.) I have no more lower back or knee pain from squatting.

Focus on a slow, controlled eccentric.

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My isometrics right now are (as in the article) Single leg wall sits and Spanish Squats for 5 sets x 1min 3x everyday. They kind get easy now so i’m gonna hold a weightplate or a kettlebelle and so on.

I’m switchin my 5/3/1 to a Full body template 3d/w, but with a few tweaks.
The template is not definitive cause i have to try out what works best, but considering doing something like this:

Day 1
Box Squat Var. 4x15, 4x12, 4x10, 4x8, 4x6 (progressing through the weeks)
Split Squats 4x15, 4x12, 4x10, 4x8, 4x6 (progressing through the weeks)
Bench 5/3/1+
Back work

Day 2
Deadlift 5/3/1
Deadlift 3-5sets x 5-8 reps @ FSL
OHP 5/3/1 work and/or Back work (not sure right now)

Day 3
Box Squat Var. 4x15, 4x12, 4x10, 4x8, 4x6 (progressing through the weeks)
Split Squats 4x15, 4x12, 4x10, 4x8, 4x6 (progressing through the weeks)
Bench 3-5sets x 3-8reps @ FSL
Back work

Every training day foamroll my abductors and strenghten my adductors.

With that type of work, you’re getting enough stimulus for your tendon. All I’d do is make sure you’re getting the knees far, far over the toe on the split squats. I’d consider using a front foot elevated split squat to help get there

This one sounds super counterproductive imo. I feel like the pain gets worse during squatting when my knees go too far in front.

Thats the unfortunate reality of managing tendinopathy, you need to strain the tendon and the quads. Tendinopathy rehab actually involves training through 3-4/10 pain initially

The patellar tendons strain will increase as you go into deeper and deeper knee flexion. To improve tendon resiliency, you need to go over toes.

Start light and build up over time. Use isometrics before training to reduce the sensitivity of your tendons.

As the tendon resiliency improves, your pain will reduce

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Sry for late response…

thx for those advises and tipps. I’m currently finishing my last cycle of 5/3/1 before changing the template. My new split is not fished yet, i will post my template and my progress on PT rehab.

thx a lot

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Weight-bearing squats often challenge the extremes of the knees. Personally, I think the safety bar box is better

Problem is first, i don’t have a Safety bar, second a normal box squat copresses my low back so hard that i get a lot of pain before i even fatigue my quads EVEN with slow movement, this is why i asked about Safety, Zercher or Front. Zercher i cannot handle that much weight before it slips, so i tried Front Box Squads FIRST, not bad, then i tried Normal Front Squads (Olympic grip), almost no pain.

I think you’re missing @j4gga2’s point - you doing everything to avoid knee flexion is not helping your weakness. I like goblet squats with the heels elevated. Knee flexion is not a bad thing, but you have to do the thing that is uncomfortable at a light load and progress upwards if you ever want to fix it.

I had patellar pain for like 6 months and did all of your tricks to avoid letting my knees track over my toes, and it stopped the pain while I was working out but did nothing to fix the problem. You need to strengthen that area, not avoid it.

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