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3 Top tips to prevent patellar tendonitis
Running man wants to prevent patellar tendonitis.
Kim Van Deventer
Nov 5, 2022
Need advice on how to prevent patellar tendonitis? Look no further. This article shares key risk factors for patellar tendonitis and 3 practical tips to prevent it!

Ask any runner who's dealt with patellar tendonitis, and they'll likely tell you the same thing: It's much easier to prevent patellar tendonitis than treat it.

Patellar tendonitis is a complex condition to treat because there's no single cause, and multiple factors can often contribute to it. These factors can be intrinsic (within your body) or extrinsic (outside your body); some you can control, and others you can't.

To prevent patellar tendonitis, you first need to know these risk factors. So, let's start by looking at the most common risk factors and which ones are within your control.

Intrinsic risk factors

Intrinsic risk factors originate from within your body and impact patellar tendon load. The most common include:

Kinetic chain disturbances (from strength and flexibility issues)

Your kinetic chain refers to how your body’s bones, joints, muscles, and tendons align and work together to move you. When any part of this system doesn't line up correctly or function optimally, it can throw your biomechanics off and increase the strain on your patellar tendon.

Strength imbalances and flexibility issues are the main reasons for your kinetic chain to be disturbed.

For example, muscle strength imbalances (when some muscles are stronger than others) in your hips and legs can change how you move and lead to uneven forces passing through your patellar tendon.

A lack of flexibility can also cause kinetic chain problems, impacting your patellar tendon. For example, evidence suggests that reduced quadriceps and hamstrings flexibility and ankle joint mobility can increase your risk of developing patellar tendonitis.

The kinetic chain of your body is important for patellar tendonitis prevention.

Age

As you age, your tendons naturally change. For example, they become thinner, can’t store as much water, and lose some elasticity and strength. Healing also takes a little longer because your circulation slows down naturally with age.

All these changes can increase your risk of developing patellar tendonitis, so addressing or adapting to these changes is crucial. More on this later.

Genetics

Research shows that genes determine your athletic performance, how your body responds to its environment, and what causes you to become injured. Your genetics also control your metabolism and ability to heal.

Extrinsic factors

Extrinsic risk factors impact your tendon from the outside and are considered the most common causes of patellar tendonitis. The most common extrinsic factors are:

Training errors

The way you structure your training can lead to tendon overload and injury.

These include aspects such as:

1
Sudden increases in training or running volume and intensity
2
Not adding enough variation to your training activities
3
Allowing insufficient rest and recovery time between workouts
4
Doing high-impact activities without proper preparation

Poor technique

Poor form during training and workouts or a running style that overloads the front of your knee can increase the strain on your patellar tendon and cause injury.

Improper footwear

Wearing shoes that don’t provide the right type of support for your foot and ankle can impact your body alignment and add extra load to your patellar tendon.

Hard or uneven training surfaces

Running on harder or uneven surfaces can increase the forces going through your knee and, in turn, your patellar tendon.

Minimize this extrinsic risk factors for patellar tendonitis prevention.

Now that you know the main risk factors, the big question is: Which ones can you control?

Which risk factors can you control?

Great news! You can control almost all these factors. The exceptions are your age and genetics. But just because you can't change these factors doesn't mean you're destined to develop patellar tendonitis. There are ways to work around them. Here’s how.

Preventing patellar tendonitis as you age

While you can't change your age, there are things you can do to help reduce the impact of aging on your tendons and keep them safe from injuries.

An important thing to note is that age-related changes in the musculoskeletal system are generally due to inactivity rather than simply getting older. So, by being a runner, you can already consider yourself ahead of the game in preventing age-related patellar tendonitis.

As you age, you may need to take a few extra steps to support your tendon health, considering the natural changes happening in your tissues. These steps include:

  • Focusing on good nutrition: Various nutrients such as proteins, amino acids (leucine, arginine, glutamine), vitamins C and D, manganese, copper, zinc, and phytochemicals can help improve tendon growth, healing, and recovery (you can get all these through a balanced diet, so speak to a doctor or dietician if you need advice on this)
  • Doing regular strength training: Heavy-resistance training can improve your tendon's structure and function, helping them maintain their ability to take on and adapt to stress and load (the Injury Prevention Plan in the app can help you with this)
  • Having healthy lifestyle habits: Avoiding alcohol (and other toxins), getting enough sleep, and keeping hydrated can improve your ability to heal and recover after exercise

These simple strategies can help improve your tendon health regardless of age, but they become more crucial as you age.

Old man runs to improve his tendon health and to prevent patellar tendonitis.

Genetics and preventing patellar tendonitis

The research in this area is limited. So when it comes to genetics and tendon injuries, it’s best to be mindful of any inherited conditions you or your family have and become really good at understanding how your body responds to exercise.

If you're a seasoned runner, you've likely already learned what your body can handle and what it can't. However, if you're new to exercise or have a family history of tendonitis, it's important to take things slowly and gradually increase your activity level, allowing enough recovery time between training sessions.

Now, considering all this, let's look at some practical tips for preventing patellar tendonitis.

3 Proven tips to prevent patellar tendonitis

Tip 1: Don't ramp up your running volume too quickly

Your tendon needs time to grow stronger in response to training. Increasing your running volume too quickly means that your tendon may not be strong enough yet to take on that load. As a result, it can become overloaded and develop tendonitis.

What you can do:

1
Volume increase
Avoid sudden increases in training intensity or volume.
2
Beginner / after a break from running
If you're just starting with running or coming back from a break, make sure to increase your mileage gradually. A general rule is not to increase your weekly mileage by more than 10%. This is a safer way to allow your tendon to adapt to the new load.
3
Experienced runners
If you've been running for a while and your body is well-conditioned, some research indicates that increasing your mileage by up to 20% may also be OK.

Tip 2: Make rest, recovery, and variety a part of your routine

Rest and recovery are essential for tendon healing, repair, and growth. If you give your tendon enough time to recover after exercise, you can help prevent patellar tendonitis.

This doesn't mean you must take complete days off from all activity, but make sure to schedule enough rest time, easy days, and cross-training into your routine.

What you can do:

1
Allow enough recovery time after intense training sessions
Aim to give yourself at least 48 hours to recover after high-intensity sessions that include hills, speed work, or plyometrics (or more, depending on your training status, health, and age).
2
Build in a recovery week every 3 or 4 weeks
If you've not been able to recover properly each week, bringing your overall training intensity and volume down for a week in the month can help your tendon catch up on its recovery time.
3
Vary your training
Don't push to your limits in every session, and try mixing up your training surfaces, runs, workouts, and sports.

Tip 3: Optimize your kinetic chain

Any area in your kinetic chain that is out of balance or not working well can predispose you to injury.

To prevent patellar tendonitis, you need good alignment, muscle strength, flexibility, and joint range of motion to keep excess strain off your patellar tendon.

While you don't have to be super flexible or strong, some studies show that not having enough muscle flexibility and range of motion in certain areas can put you at a greater risk of developing patellar tendonitis.

The way you move can also impact the amount of load passing through your patellar tendon.

What you can do:

1
Mobility
Keep your joints and muscles mobile and flexible, so all the parts in your kinetic chain can move freely.
2
Strength training
Do regular strength training for your calves, core, and leg muscles to help share the load with your patellar tendons.
3
Movement economy
Check your form and body alignment during exercise and while you run to make sure you’re moving in the most efficient way and not overloading your patellar tendons.

The Exakt Health app's prevention plan covers all of 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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Conclusion

Patellar tendonitis is a common injury among runners of all ages and levels. The good news is that there are things you can do to prevent it.

In this article, we highlighted the most common risk factors (from the research) and gave you our top 3 tips to prevent patellar tendonitis. To recap, we suggest you:

  • Make sure you don't ramp up your running volume too quickly
  • Always allow enough recovery time for your tendon to heal after workouts, training, or events
  • Keep all the structures in your kinetic chain strong, flexible, and well-aligned

Our last suggestion is to be mindful that your age and genetics may also contribute to developing the condition. So try to find ways to work around these risk factors if they apply to you.

Patellar tendonitis doesn't have to derail your running goals. Understanding the risk factors and following the tips mentioned in this article can help you prevent the condition and keep you running injury-free for years to come.

Kim Van Deventer
Kim Van Deventer is a freelance healthcare writer and digital content strategist for healthcare businesses and medical content agencies. She worked as a physiotherapist for more than 14 years, specialising 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.
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