General Measures

• A progressive exercise program is the main focus of treatment.
• Strength and flexibility exercises are needed to increase the strength and control the quadriceps muscle as well as to stretch the quadriceps, hamstrings and tendoachilles complex.
• Straight-leg-raising program can help to strengthen the quadriceps:
  • This can be performed several times each day as a home exercise program or formally with physical therapy in more recalcitrant cases.
  • Quadriceps, hamstrings and tendoachilles stretches can be performed at the same time intervals as the strengthening program.
• Patients can be advanced from low-resistance exercises such as swimming, stationary bike, and elliptical trainers to higher level running activities.
• Activity restriction in the initial acutely symptomatic stage is instituted to eliminate high-impact sports, including especially those that involve running and jumping.