Tendinopathy is often diagnosed as tendinitis and they two can appear very similar.

What to do if you keep retwisting your ankle when running

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