Prevention

Unfortunately, people with patellar tendinopathy typically learn after the fact what they could have done differently to prevent getting tendinitis in the first place.

Though it sounds simplistic, the way to avoid getting the chronic form of tendinitis -- tendinosis -- is that you need to first avoid getting tendinitis.

Some tips to avoid patellar tendinitis:

-- Tendinitis is typically an overuse injury. Therefore, activity must be ramped up slowly when the sport involves repetitive motion. This applies both to a new sport or a sport you are re-starting after a seasonal break. So, if you are re-starting bicycling, for example, after taking a season off, start slowly. Over the first month or so, increase gradually the amount of time you spend cycling. Similarly, the level of resistance should be advanced over a period of time -- start with flat surfaces with easier gears. Many people develop problems when resuming an outdoor sport after a winter break. When the weather improves, they go out and overdo it.

-- Stretch on a daily basis. I also recommend occasional professional massage appointments.

-- If you feel pain around the knee after significant repetitive motion, then STOP. You may need to take several days or more off, and very gradually resume the sport. You may need to seek medical help as well.

-- Be mindful of minor symptoms around the knee when engaged in repetitive motion sports. Minor symptoms may be a warning sign that things can get much worse if you aren't careful. If minor symptoms persist for several days, you may need to completely stop what you were doing, try to figure out what went wrong and take significant time off. Do the symptoms suggest "overuse" in time or resistance? Did you recently start a sport or resume a sport after a season off? If the minor symptoms are in any way related to overuse, be especially careful.

-- Be particularly cautious if you already have developed another knee condition, such as Iliotibial Band Syndrome, which may increase the odds of developing other knee problems.

If you do develop tendinitis, the following are tips to help prevent it turning into tendinosis:

-- Seek medical attention to verify it is tendinitis and provide you with advice to reduce bothersome inflammation.

-- Avoid walking long distances. Avoid stairs. Avoid carrying heavy objects, which can increase strain on the knee. Avoid repetitive motion exercise that require you to bend and straighten the knee repetitively until your symptoms have substantially improved.

-- Avoid doing whatever led to the tendinitis. Be careful when resuming that activity once your symptoms have improved.

-- If you seek physical therapy, be particularly careful. Treatment should focus initially on light stretching. Avoid exercises that require you to flex and extend the leg. In the early phases, improper physical therapy can make things worse.

-- Do NOT do eccentric exercises. Eccentric exercise should be done ONLY after the tendinitis has become tendinosis, which may be many months later.

--Have fun when the warm weather returns but avoid overdoing exercise. Remember, you want to be able to be active for the long haul, it's not worth risking injury just because you finally can spend a day outside doing a favorite or a new sport.