Do physical or imaging changes explain the effectiveness of progressive tendon loading exercises? A causal mediation analysis of athletes with patellar tendinopathy

The beneficial effect of PTLE on patellar tendinopathy was not mediated by changes in physical properties, tendon thickness or degree of neovascularization. Healthcare professionals may consider exploring other potential factors when managing patients with patellar tendinopathy, but further large-scale research is needed to confirm these results and to identify alternative treatment targets.