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Top training tips to prevent patellar tendonitis in runners

We share our top tips on how to prevent patellar tendonitis when running.
Kim Van Deventer
Kim Van Deventer
Feb 28, 2024
Medically reviewed by
Maryke Louw
Preventing patellar tendonitis becomes pretty straightforward once you understand what running errors cause it.

So, let's kick this article off by taking a quick look at what happens to your body when you exercise and how this impacts your injury risk.

How exercise makes us stronger

The trigger - Micro-injuries

Our bodies sustain micro-injuries whenever we exercise (walk, run, strength train, etc.). These micro-injuries affect all of our tissues and are the important first step in how exercise makes us stronger.

The number of micro-injuries that occur depends on how used our bodies are to that type, intensity, and volume of exercise.

Your body will typically experience more microdamage if:

  • It's a new type of exercise
  • It's a much harder training session than what you're used to

The patellar tendon specifically takes more strain during hill running and sprint sessions.

The cycle of micro-injury repair.

The reaction - Repair and strengthen

While running is the part of training we most enjoy, it's actually what you do in the hours after a run that determines your training gains.

Your body uses the recovery period after a run to repair the micro-injuries. But it doesn't just fix the damage. Your brain also wants to avoid future damage, so it gives orders to make that area of your body more robust than before.

As a result, your body (muscles, tendons, bones, etc.) slowly grows stronger over time.

This micro-injury repair cycle has a compounding effect on your strength and endurance, making you stronger and fitter over time.

This is why an experienced runner, who has consistently trained for several years, can usually handle a much higher training load than a novice.

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Male runner using the injury prevention plan in the Exakt Health app to stop his patellar tendonitis recurring.

How micro-injuries can lead to patellar tendonitis

The training errors that lead to overuse injuries like patellar tendonitis boil down to one of two things:

  1. Not prioritizing recovery - the micro-injuries accumulate if the post-exercise repair cycle can't be completed
  2. Increasing training volume or intensity too quickly - may cause excessive microdamage.

You can find a more detailed discussion about the causes, symptoms, and treatment of patellar tendonitis here.

Our top tips for preventing patellar tendonitis

1. Use a running plan that's tailored to you

A running plan can be an excellent tool to ensure you achieve your goals and avoid overtraining. But only if it's designed around your specific training habits, strength, and endurance.

If the plan requires you to suddenly run a lot more miles, more frequently, or do more high-intensity workouts than what you're used to, it will likely lead to an injury.

A running plan can help prevent patellar tendonitis but only if it's tailored to you

A tailored running plan must...
1
Consider your history
Start with a running volume that is equal to or only slightly higher than what you are used to. One way to calculate this is to look at what you've been doing over the last 4 weeks before starting the plan.
2
Gradually increase your running distance
By no more than 10 to 20% per week.
3
Slowly increase in intensity
If you've never done high-intensity workouts, it's usually best to only do one per week.
4
Vary in intensity
Have a mix of easy and harder runs.
5
Be flexible
Allow you to run on your preferred days and add more recovery time if needed.
6
Have planned recovery weeks
That maintain your fitness gains while allowing your body to catch up on repairing microdamage that may have accumulated. More on this later.
7
Include mobility and strength workouts
That are appropriate for your current level of strength and flexibility. These help you move more freely and spread the forces from running more evenly.
8
Adjust your strength workouts to suit your running and competition schedule
Trying to maintain a high volume of strength training while also increasing your running training significantly (e.g., during marathon training) can lead to overload.
Stiffness or weakness in one area of our body can increase the strain on other parts. For example, evidence suggests reduced quadriceps and hamstring flexibility and ankle joint mobility can increase your risk of developing patellar tendonitis.
Stiffness or weakness in one area of our body can increase the strain on other parts. For example, evidence suggests reduced quadriceps and hamstring flexibility and ankle joint mobility can increase your risk of developing patellar tendonitis.

The Exakt Health app's Running Injury Prevention Plan covers all these elements (strength, flexibility, control). We've also included advice to help you understand and manage the other areas of injury prevention, such as scheduling training and recovery methods.

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Female runner using the Exakt Health app to prevent patellar tendonitis.

2. Frequently assess your recovery

Wouldn't it be nice if there was a recipe we could follow that guaranteed 100% recovery after every workout?

Maybe one day we'll have a gizmo that tells you if you train this hard, rest for x hours, and eat y food, and you'll be ready to go. But for now, because so many factors impact it, recovery remains an (educated) guessing game.

So, the best we can do is try to get the basics right and look out for signs that perhaps our bodies are tired and not fully recovered.

Five signs that your body needs more recovery

1
You're still achy and sore
from your previous training session.
2
Feeling tired
all the time.
3
Struggling to sleep
despite feeling tired.
4
Being ratty
and short-tempered with people you actually like and love.
5
If you measure heart rate
changes in your resting heart rate and heart rate variability can also indicate that your body is tired and overworked.

If you notice any of these signs, take action!

Recovery doesn't always have to mean complete rest. Simply reducing the intensity of your workouts for a while or choosing low-intensity cross-training sessions (like swimming or cycling) might do the trick.
Sometimes, it's best to rest completely for a few days, but often it's simply a case of adjusting your training intensity for a while.
Sometimes, it's best to rest completely for a few days, but often it's simply a case of adjusting your training intensity for a while.

You can improve your recovery by doing the following:

  • Eating enough of the right foods (balanced diet) - your body can only repair if you provide it with the correct building blocks
  • Getting enough sleep
  • If you're a new runner, avoid training every day (running challenges are great for getting injured!) - your body will need quite a few months or even years of consistent training to build the capacity to handle daily training loads
  • Leaving at least 48 hours of recovery time after high-intensity training sessions
  • Building a recovery week into your training (usually every 4 weeks) where you drop your training volume and intensity significantly (by 20% or more) to allow your body to catch up on repairs that might be lagging behind
  • Taking steps to manage your stress levels (work and personal) - chronic stress fatigues both body and mind
More about patellar tendonitis

Final thoughts

On paper, these tips seem pretty simple. But as runners, we know that balancing training, recovery, social life, family time, and work can get tricky in practice.

If you want help figuring out the best training schedule, what exercises to include in your injury prevention plan, and how to progress them safely, check out the Exakt Health app.

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Female runner using the Exakt Health app to manage her running training and injury prevention.
Kim Van Deventer
Kim Van Deventer
Kim Van Deventer is a freelance healthcare writer and digital content strategist for healthcare businesses and medical content agencies. She has a BSc in Physiotherapy and worked as a physiotherapist for more than 14 years, specializing in sports injury rehabilitation, chronic pain management, and women's health. Kim combines her clinical experience and digital marketing skills to create relevant and helpful content that improves patients' lives.
More about patellar tendonitis
Patellar tendonitis icon
Evidence-based injury prevention plans for Runners!
Get the Exakt Health app
Male runner using the Exakt Health app to prevent patellar tendonitis.
More about patellar tendonitis