The term tendinitis (other names – ligamentitis or tendinosis) consists of two Latin roots: tendo and itis – tendon and inflammation.
It means inflammation of the tendons, which most often, especially in athletes, affects the tendons of the patella and surrounding tissues.
What it is? ↑
Inflammation occurs at the point of contact of the bone and tendon, and sometimes along the tendon.
The disease can affect the joint at any age, regardless of gender, but most often it affects:
- people over 40;
- persons engaged in physical labor with a load on the knees;
- children and adolescents.
Fig .: knee injuries at gymnasts
Of the sports that most often lead to disease of the ligaments, cycling, basketball, volleyball and other “jumping” types can be called, so one of the varieties of tendinitis was called the “knee jumper”.
This disease affects the patellar tendon, which extends downward from the patella, is attached to the tibia and is a continuation of the ligament of the quadriceps femoris. This ligament helps to unbend the knee and lift the leg in an extended form.
More often, the disease affects the knee of the jogging leg, but it can affect both.
Exercise causes microscopic damage. With enough rest, they heal, the tissues are restored.
Otherwise, microtrauma, accumulating, lead to degeneration of tendons and the development of fatigue injuries, which include knee tendinitis.
Tendonitis can also affect people who spend a long time in an uncomfortable position.
The disease can begin with:
- tendobursitis (inflammation of the tendon sac);
- tendovaginitis (inflammation of the tendon sheath).
Tendonitis of the knee joint is sometimes confused with sprained knee tendons and ligaments.
There are the following types of tendinitis:
- acute (aseptic and purulent);
- chronic (fibrous and ossifying, arising from salt deposits).
As a result of the disease, the mechanical strength of the patella ligament is reduced, as a result of which it can partially or completely rupture.
What are the signs of Klippel Feil syndrome? Read here.
Knee tendinitis occurs for many reasons, in particular due to:
- prolonged significant load on the joint;
- injuries and numerous microtraumas;
- fungal and bacterial infections;
- diseases such as rheumatoid arthritis or gout;
- allergic reactions to medications;
- anatomical features (different lengths of legs, flat-footedness);
- wearing uncomfortable shoes;
- posture disorders;
- deforming arthrosis;
- instability and hyper mobility of the knee joint;
- weakening of immunity;
- degenerative age-related changes in tendons;
- muscle imbalance;
- parasitic damage to the body.
In accordance with the cause of the disease (absence or presence of an infectious component), two types of tendinitis are distinguished:
- non-infectious (aseptic) tendonitis;
- infectious tendonitis.
Determining the cause of the disease is a decisive factor in prescribing treatment, which as quickly as possible will lead to a complete cure.
Long-term intake of glucocorticoids and systemic diseases such as rheumatoid arthritis, chronic renal failure, systemic lupus erythematosus, diabetes mellitus can be provoking factors.
Symptoms and signs of the disease ↑
Typical manifestations of tendonitis, by which one can judge the presence of the disease, include:
- sudden pain in inflamed and nearby areas;
- pain on the weather;
- limited mobility in the joint;
- hypersensitivity when probing;
- redness and swelling in the affected area;
- creaking of the joint when moving.
Sudden sharp pain may occur when climbing stairs and get up from a chair.
It interferes with work and lead a normal life, and even more so in sports.
Typical symptoms are easily detected by careful inspection of the knee and palpation of the attachment of the ligaments to the kneecap.
With deep localization of the process, pain occurs when the ligament is deeply pressed.
Degrees of development развития
In the development of the disease there are 4 stages:
- pain is manifested only after large loads;
- paroxysmal dull pain occurs with standard and even weak loads after exercise or physical work;
- more intense pain may appear at rest;
- as the pathology progresses, the patellar ligament may break.
For the appointment of adequate treatment, it is necessary to verify the diagnosis not only because of the occurrence of the disease, but also according to the stage of development.
Diagnostic methods ↑
To clarify the diagnosis, a doctor can be assigned diagnostic examinations:
- Laboratory research. Show changes only in cases where tendinitis occurs against the background of infection or rheumatoid process.
- X-ray The results of X-ray examinations indicate only pathology in the last stages of the disease, associated with the deposition of salts and when tendinitis occurs as a result of arthritis or bursitis (inflammation of the articular sac).
- CT and MRI. Computed tomography and magnetic resonance imaging help to identify breaks and degenerative changes in tendons that already require surgery.
- Ultrasound. Ultrasound examines a change in the structure or shortening of the tendon.
Proper diagnosis allows you to determine not only the presence of the stage of development of the disease, but also to determine which tendon and in which place is susceptible to inflammation.
The specified diagnosis sounds in more detail, for example, “tendonitis of the internal lateral ligament of the knee joint stage 3”, which is set for inflammation of the internal collateral ligaments of the knee joints.
This differentiation makes it possible to determine the need for mobilization, its duration and methods of treatment.
If your knee hurts, which doctor should you go to? The answer is here.
Worried about pain in the shoulder joint when moving the arm back? Find out what this may be related to in this article.
Treatment of tendinitis of the knee joint ↑
Knee tendonitis in modern conditions is treated:
- physiotherapy methods;
- folk remedies;
- physical therapy.
Diseases at stages 1, 2 and even 3 are amenable to conservative treatment methods.
First of all, you should limit the load on the joint or even fully immobilize it.
To reduce the load on the knee, use crutches or a stick, and to immobilize the knee, they cast or put a splash on it.
A combination of physiotherapeutic procedures and medical preparations is used.
Photo: splint for immobilization of the knee
If the disease develops adversely, surgical intervention is prescribed.
To unload the patellar tendon, use:
- taping (attaching special tapes or tapes to the knee);
- wearing an orthosis (knee pad).
Orthoses are an effective treatment for diseases of the knee joint and are suitable for preventing damage to tendons in the course of training, fitness and gardening.
Photo: knee orthosis
For chronic forms of the disease, massage is recommended.
Video: knee taping
Anti-inflammatory and anesthetics from the group of nonsteroidal drugs (for example, naproxen and ibuprofen) are prescribed from drugs.
Medicines relieve pain and inflammation, but do not lead to full recovery. They can be administered orally, in the form of injections (to achieve a quick effect) and in the form of gels, ointments and creams externally.
Prolonged use of nonsteroidal drugs may adversely affect the gastric mucosa, so their appointment is limited to two weeks.
With low efficacy of these drugs to relieve pain and inflammation, injections of corticosteroids and platelet-rich plasma are injected into the lesion.
In case of a pronounced inflammatory process in cases of an infectious origin of tendinitis, antibiotics and other antibacterial drugs may be prescribed.
Injections of corticosteroids help relieve pain, but it is dangerous to abuse them, as they can weaken the tendons, which is fraught with their rupture.
Platelet-rich plasma injections are a new treatment method that promotes tendon tissue regeneration.
Of the physiotherapeutic methods of treatment that have a positive effect in the treatment of tendinitis, they use:
Special exercises of exercise therapy for stretching muscles and their strengthening, which also contribute to the restoration of the tendon after treatment, help.
At the 4th stage of the disease with an tear or complete rupture of the tendon surgery is necessary.
Surgery to remove degenerative tissue in the patella area is of two types:
- arthroscopic (endoscopic surgery);
- open (through the usual incision).
If there is a bone growth on the patella, leading to the incision of the ligament, it can be removed arthroscopically, that is, through tiny incisions.
If cysts or other volumetric changes appear in the bundle, they are corrected only with the help of an open operation.
Sometimes other than excision of degenerative tendon sites. during the operation, scraping is performed in the lower part of the patella, as a result of which the regenerative process is activated.
At the last stage, the patellar ligament is reconstructed to restore the functions of the quadriceps femoris.
Many doctors consider it necessary to shorten the lower pole of the patella when operating the knee joint tendonitis, because they believe that because of this, ligament incarceration occurs.
During the operation, Goff’s fatty body can be partially or completely removed and the ligament attachment site can be moved in case of an axis violation.
Surgical intervention is also carried out in case of stenosing tendonitis (a disease with constriction of blood vessels).
If the disease is accompanied by purulent tendovaginitis, an urgent and an autopsy is performed with the pus pumped out from the tendon sheath.
The postoperative period is from two to three months.
Treating tendonitis with homemade folk remedies involves removing pain and inflammation by acting both from the inside and outside.
Oral admission allows medicinal drugs to enter the blood through the gastrointestinal tract, and local – to penetrate the active substances directly through the skin.
For oral administration it is recommended:
- drink twice a day tea from 1 teaspoon of a mixture of equal parts of crushed sassalaria and ginger roots;
- 0.5 grams of curcumin per day used as a seasoning for food to relieve pain and inflammation of the tendons;
- take an 18-day brew with 0.5 liters of vodka, a glass of walnut partitions 3 times a day in a tablespoon (it is not shown categorically for those driving a car);
- take as a tea cooked in a water bath decoction of 1 tablespoon of dried berries of bird cherry or three spoons of fresh berries in a glass of water.
At home for local external use is recommended:
- immobilization of the joint with a splint or bandage;
- ice massage (rubbing) with pieces of ice for 15-20 minutes;
- a compress with aloe juice from cut leaves that have lain for 24 hours in the refrigerator (on the first day 5-6 times, then for the night);
- contrast procedures at least three days after the ice has been treated by the knee;
- ointment with arnica to relieve inflammation and swelling for three daily lubrication;
- lotion from infused (within half an hour) two tablespoons of crushed ginger in two glasses of boiled water three times a day for ten minutes.
If the joint is not hot to the touch, you can proceed to compresses and contrasting procedures.
They consist in alternating the massage with ice and warming up with millet grain heated in a pan and placed in a cotton bag or sock.
This procedure improves blood circulation and promotes tissue repair.
In the initial stages and chronic forms of treatment of tendinitis folk remedies can bring significant relief, but before it starts, you should consult with your doctor.
An important role in the prevention and treatment of diseases of the 1st and 2nd stage is assigned to physical therapy.
Exercises are designed to stretch and strengthen the quadriceps.
Exercise therapy classes can take up to several months before full recovery and the opportunity to begin training or normal physical activities.
Pic .: quadriceps muscle of thigh
Good effect is provided by yoga.
The complex of physical therapy exercises include:
- stretching the posterior thigh muscle groups;
- stretching the quadriceps muscle of the thigh;
- knee extension with resistance;
- the rise of the legs sideways from the lying on its side;
- raising the straight leg up to half from the “supine” position;
- walking with resistance;
- swing a foot with resistance;
- squeezing the ball with your knees, leaning your back to the wall;
- step with rise on height of two bricks;
- isometric contractions of the thigh muscles, bending the knees in the sitting position.
Professional athletes are recommended after the disappearance of pain to add squats on the squat (inclined plane) with and without burdening.
After treatment to return to sports or to the usual significant physical exertion and to prevent relapse, rehabilitation is of great importance, especially for athletes.
Exercises are performed with a gradual, in several stages, c increase in load.
After exercising the eccentric stretching of the quadriceps, ice is applied.
A return to the previous volume of loads is permitted in the absence of pain and discomfort during classes and the restoration of the volume of quadriceps contraction to 90%.
To avoid disease, it is enough to take precautions:
- warm up all muscle groups before the athletic load;
- do not perform long exercises on one muscle group;
- when lifting weights, bend legs at the knees;
- avoid sudden movements;
- avoid monotonous movements and postures during the day;
- for the prevention of injuries and overloads of load to increase gradually;
- regularly change the type of loads;
- rest in time.
Like any other disease, tendonitis is easier to prevent than to treat it later.
In modern medicine, there are many opportunities for curing tendinitis of the knee joint, which lead to a complete cure for all medical recommendations.
Like this article? Subscribe to site updates via RSS, or stay tuned to VKontakte, Odnoklassniki, Facebook, Google Plus, My World or Twitter.
Tell your friends! Tell about this article to your friends in your favorite social network using the buttons in the panel on the left. Thank!