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Mark Agnew

A common issue for runners is to feel pain at the front, or front bottom, of their knee cap.
If you experience this symptom, you may have patellar tendinopathy. It is sometimes called runner’s or jumper’s knee.
Here are some of the best ways to treat it.
What is patellar tendinopathy?
Tendinopathy is a breaking down of the tendon cells. The patella is the knee cap, while the patellar (with an ‘r’) is the tendon that attaches to the shin bone, or tibia.

So, patellar tendinopathy is an injury to the tendon that attaches the knee cap to the shin, and is technically a breaking down of the cells.
Tendinopathy is often diagnosed as tendinitis and they two can appear very similar.
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Tendinitis is the swelling of the tendon, and may require anti-inflammatories.
But tendinopathy requires increased blood flow to heal the tendon, so anti-inflammatories may hinder the healing process, therefore medications should be used with more caution according to studies.
What is the cause?
For runners, the most common causes are either over use or a sudden strain.
Overuse means different things to different runners – if you are new to running and trying to do too much, too fast, too soon, you are likely to pick up an overuse injury in one tendon or another.

Overuse can also come from lack of variation, such as only running on roads, or track, or on a slanted surface (like a pavement, beach or running track), and always in the same direction.
The sudden strain can come from changing direction quickly, jumping and landing without a brace, or sprinting on a hard surface without the proper footwear.
What are the symptoms?
Symptoms include:

A dull ache around the knee


Pain when walking, running, jumping or standing up


Tenderness to touch


A creaking sound as your flex the knee


Weakness – you may not be able to lower yourself into your seat, instead you flop back with no strength in the knee joint. Or maybe you cannot go down stairs without support

Treating patellar tendinopathy

Rest – Do not run as you will only make things worse.


Avoid ice – As mentioned, tendinopathy is often confused with tendinitis, but the latter needs ice to reduce the swelling. You want to encourage blood flow to the tendon if it is tendinopathy, so ice will only hinder the healing process


Try heat – a hot-water bottle will promote blood flow to the area


Self-massage – promote blood-flow to the tendon by rubbing and massaging it


Light exercises – when it is sufficiently healed for some movement, promote blood flow to the tendon with some light exercises, like slowly straightening and bending your leg


Be patient – tendinopathy can take a long time to heal

Prevention
Preventing tendinopathy or preventing it from returning, is preferable to treatment.

Eccentric loading – strengthen your tendon by slowly squatting. Slowly lengthening the tendon under load will heal and prevent tendinopathy


Strength training – having strong leg muscles will support the knee joint. Add strength training to your programme – squats, lunges, split squats. It will also improve your running


Shoes – if your shoes are old, ill fitting or just not suited to your gait, get a new pair. You can find running shops which will give you advice on the best shoe for you, though it might just come down to personal preference


Gait and coaching – running seems easy, right? Well, you might want to hire a coach or get some gait analysis to see if you are doing it wrong. An ungainly gait might be putting extra pressure on your knees


Variation – mix it up. Try running on different surfaces, like trails. Try different intensities – like fartlek training or long slow runs


Cross training – along with weight training, try other exercises. Cycling, swimming, rowing or other sports will improve fitness and help prevent over use injuries


Build up slowly – your cardiovascular system will get fitter more quickly than you tendons will get used to the load. Even if you are getting fit, build up the miles slowly and do plenty of cross training to keep pushing yourself while not overloading your tendons



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Pain at the front of your knee when running? You might have patellar tendinopathy

Patellar tendinopathy is a breakdown of the cells in the knee tendon. Photo: Shutterstock 

Even simple tasks like standing up or sitting down can be painful with tendinopathy. Photo: Shutterstock

Rest, but do not ice your knee. You want to encourage blood flow to the tendon. Photo: Shutterstock 

Pulling your calf muscle when running: treatment and prevention

A calf pull can be sudden and painful. Photo: Edmond So

A physiotherapist will be able to help you with your pulled calf muscles. Photo: Edmond So

Do not forget to warm up before you go on your run. Photo: Shutterstock

Do not rush back to running. Give your calf time to heel. Photo: Shutterstock 

Flexibility and mobility will help prevent any calf tears. Photo: Shutterstock 

What should I do if I keep retwisting my ankle when running? Cause and solutions

Twisting and re-twisting your ankle is frustrating when all you want to do is run. Photo: Dickson Lee

Cannot get the start line because you keep twisting the same ankle? Rest, easing into running and strength and stability are key to mitigating a recurring injury. Photo: Dickson Lee

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Patellar tendinopathy is a common running injury caused by overuse or weak muscles in runners
There are easy preventions and cures that will make you more resilient to injuries and a better runner too


Patellar tendinopathy is a common running injury caused by overuse or weak muscles in runners.


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