Calcific Patellar Tendinopathy. A Case Report Integrating Diagnostic Ultrasound Throughout a Multi-Modal Treatment Approach.

International journal of sports physical therapy · 2026 · Case Report · PT
Ian Young, Adam Salzman, James Dunning, Joshua Prall, Sam Fischer, Brittany Forbes, James Escaloni

One 46-year-old woman with calcific patellar tendinopathy improved in pain, function, and tendon ultrasound appearance over 11 months using dry needling, spinal manipulation, and progressive exercise together. This is a single case, not proof the approach works, and no component can be isolated.

Key findings

1

The patient started at 7/10 pain and 50/80 on the LEFS. Her pain met the 2-point minimal clinically important difference within three weeks, and her LEFS exceeded its 9-point threshold at every follow-up. By three months she met all her goals, and at 11 months she squatted 215 pounds without pain.

2

Treatment combined HVLA thrust manipulation at every session, ultrasound-guided dry needling with electrical stimulation from weeks 2 through 12, blood flow restriction exercise in weeks 3-6, and progressive strengthening. The patient was seen twice weekly for 12 weeks, then twice monthly for six months.

3

Ultrasound showed calcific deposits and partial tendon tearing at baseline. By three months the deposits were smaller and fewer, and by 11 months the tendon had a more fibrillar appearance with no pain on probe pressure.

MethodologyResultsClinical Relevance

Single-blind randomized controlled trial. Sixty-four participants were randomized across two intervention arms and assessed at twelve weeks for the primary outcome…

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Summarised by AI from the abstract, not the full paper. Check it against the source before it changes what you do. Read it on PubMed