I have mild patellar tendinopathy, and would like to still get cardio in. I have an elliptical, but wonder the best way to leverage it while minimizing stress on the patellar tendon/quad. I know with biking, it is recommended to bike in reverse to unload the quad. Would using an elliptical in the opposite direction also do this? Or would using it forward be easier on the patellar tendon? Or is elliptical too hard on it?

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    What was the activity that caused the tendinopathy? If you got it from using the elliptical in the first place vs some completely unrelated activity, the answers will probably be quite different. Nov 16, 2020 at 3:23
  • Got it playing basketball... never used an elliptical really
    – BOUNCE
    Nov 16, 2020 at 13:19
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    decline eccentric pistols fixed my patellar tendonitis after I found this website (I built my own cheap box) myfivefingers.com/knee-exercise
    – michael
    Nov 16, 2020 at 15:02

1 Answer 1


You can consider swimming. Sometimes the issue may arise from muscular imbalances around the knee.

Personally I have tight quads and weak hamstrings. So it gave me some knee issues. Now I’m working to release my quads and strengthen my hamstrings.

I’m not sure what you mean by reverse biking but anything that involves knee extension (straightening knee) will recruit your quadriceps.

  • by reverse biking i meant legs making a counterclockwise motion instead of clockwise motion on the bike... firing the hamstrings instead of the quads... sorry should have been more descriptive
    – BOUNCE
    Nov 16, 2020 at 20:22
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    Gotcha! But at the bottom of the movement, you will still need to extend your leg. I am thinking you might actually fire more hamstring doing the “usual” cycling direction as the reverse biking may also rope in your hip flexors (when you are pulling the pedal towards you with your feet). But it depends on the ankle you are cycling too
    – Jun
    Nov 17, 2020 at 3:33

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