Practical Guide: Isometric Exercises for Tendon Healing

Daehan Kim. M.Sc., NASM-CES, CSEP-CEP., NSCA-CSCS
Oct 3
5 min read

Updated: 4 minutes ago

If you’ve landed here, you may have been directed by a handout from the 2025 Canadian Association of Orthopaedic Medicine conference or arrived from my first blog post on tendon rehab, where I explained why isometric loading is effective for stubborn tendon pain. If you’re a patient who has come across this page independently and would like a brief overview of the science behind isometric exercises for tendon rehab, I recommend reading this article first: Why Isometric Loading May Be the Key to Healing.

If you are here for the video demonstration, please click here.

That said, this post is designed to be practical. Here, you’ll find:

✅ A quick recap of the essentials, so you can follow along even if you haven’t read the first blog
📋 Isometric Loading 101: The Essentials for Tendon Isometrics
📝 A PDF handout (will be updated after October 24th, 2025) with written instructions and photos for exercises, exercise progression, protocol details, and nutrition integration
🎥 Video demonstrations for the exercises that may not be perfectly clear from photos alone — so you can see the correct technique in action

Quick Recap – Why Isometrics Matter

Tendons heal slowly and often flare up with small movements.
Isometric loading (gentle, sustained holds) helps stimulate weaker tendon fibers, encouraging repair and long-term resilience.
Done consistently, isometrics reduce pain, support tendon remodeling, and help prevent flare-ups.

Isometric loading 101

1️⃣ Two Types of Isometric Exercises

Isometrics can be applied in two slightly different ways. Both promote tendon healing, but each has a unique purpose.

Push & Hold: Gradually press against an immovable object without movement.
Hold & Resist: Maintain a position while resisting an external force.

A table that compares the "push and hold" with "hold and resist" isometrics

2️⃣ The 4-Level Progression System

To make tendon rehab safe and effective, isometrics are arranged in a 4-level progression. This ensures you start at the right intensity and gradually challenge the tendon as it heals.

A picture describing 4-level progression system for isometric tendon exercises

3️⃣ The Basic Protocol

This is the foundation you’ll return to throughout your tendon rehab journey:

Exercise: 4 cycles of 30-second holds
Rest: 2 minutes between holds
Effort level: Moderate pressure (~50% of max effort) is enough — you should feel tension in the tendon without straining
Pain guidelines: Mild discomfort (1–2 out of 10) may be okay, but avoid sharp or stabbing pain
Avoid “jerk”: Always push or pull gradually — sudden movements don’t load tendons evenly and raise injury risk
Frequency: 1–2 sessions daily (each session = 4 cycles), with at least 6–8 hours between sessions

Download the Full Handout

📥 Download the Printable PDF Handout (Will be updated after October 24th, 2025)

The handout includes:

Written instructions and photos for each exercise
Detailed protocol guidance
Exercise progression models adaptable for post-orthobiologic injection rehab (e.g., PRP, prolotherapy)
Nutrition integration guidelines
References to the scientific foundation of this approach

⚠️ While the basic protocol is designed for safe, independent use at home, nutrition and post-injection programs are supplemental and should always be integrated under the guidance of your physician. We gratefully acknowledge Dr. Pam Squire, who initiated this project and helped shape its overall purpose. She also provided valuable feedback and guidance to ensure the handout meets the standards and expectations of the physician community.

Video Demonstrations for Upper Hamstring Tendon

Level 1: Bridge without lift