What exactly makes eccentric decline squats so helpful for patellar tendonitis? : AdvancedFitness

What exactly makes eccentric decline squats so helpful for patellar tendonitis? : AdvancedFitness

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I’ve always had this question in mind. I’m new to the sub (literally found out about it just 5 minutes ago), and quite unfamiliar if this kind of question would get entertained in this sub in the first place.

I’ve read (link 1, link 2) that the eccentric decline squat is the go-to exercise for people looking to rehab their injured knees, and this fact also seems to be widely accepted in the scientific side of the fitness community.

My main question is: What exactly makes eccentric decline squats so helpful for patellar tendonitis?

Some side questions:

  • Wouldn’t the decline squat position push the knees farther out from the body, and would then increase the amount of stress on it?

  • How is this added stress beneficial to knee strengthening?

  • Do the feet really have to be flat on a slanted board, or could a person achieve the same results by having their heels placed on top of an elevated surface (like a stack of books/weight plates)?