Patellar Tendinopathy (PT) also known as Jumper's knee, is characterized by multifaceted activity-related pathology causing anterior knee pain and patellar-tendon dysfunction. It most commonly affects athletic activities that involve jumping and running. Tendinopathy is most likely to be related to mechanical loading and overuse. Athletes suffer from insidious well-localized pain, typically as the athlete starts the activity. Conservative treatment is the first line of treatment in tendinopathy, however, there is no consensus regarding the best treatment. In acute conditions, relative rest rather than immobilization is preferred. The most popular non-operative treatment involves eccentric exercise (EE). It is commonly accepted that surgical treatment must be indicated in motivated patients if carefully followed conservative treatment (physical training, injections, ESWT) is unsuccessful after 3-6 months. In recent studies, isometric and heavy slow resistance (HSR) exercises have demonstrated potential for pain reduction and functional improvement in patellar tendinopathy.

A randomized controlled trial will be conducted at the Pakistan Sports Board (PSB) Coaching Center, Lahore. 18 Subjects will be randomized into two groups; Heavy slow resistance exercises plus eccentric exercises will be given to group A and exercises of 4 sets of 10-20 repetitions will be given. Group B will give Eccentric exercises in 3 sets of 10-20 repetitions. Pre-assessments will be taken through the Numeric Pain Rating Scale (NPRS) for pain, a goniometer for range of motion, Lower extremity function assessment scale to evaluate lower limb functional impairments, and a Visa-P scale for patellar dysfunction. Assessment will be done at baseline and post 4 weeks of training. Data will be analyzed using SPSS software version 21. The normality of data will be checked, and tests will be applied according to the normality of the data, either parametric or non-parametric tests will be used (within a group or between two groups).

The objective of the study is to compare the effects of heavy slow resistance training and eccentric overload training on pain, range of motion, and lower extremity functions in runners with patellar tendinopathy.

.

Inclusion Criteria:

• anterior knee pain located on the inferior pole of the patella for at least 3 months while practicing sport;
• age between 18 and 45 years old;
• practicing any kind of sports at least 3 times a week
• score less than 80 on the Victorian Institute of Sport Assessment-Patellar questionnaire (VISA-p).

Exclusion Criteria:

• Knee surgery within the previous 6 months;
• Chronic joint diseases;
• Corticosteroid injection in the patellar tendon within the previous 3 months;
• Anti-inflammatory, analgesic, or antibiotic medications within the previous 48 hours;
• Any other concomitant treatment for PT