Orthopedics-Online

Tendonitis in the knee

definition

The term tendinitis is an inflammatory reaction, which is usually caused by excessive stress. In particular, people who are physically active are often affected by tendinitis in the knee.

A distinction must be made between two forms. In the case of a chronic course, one speaks of tendinosis. This is caused by long-term overuse of the tendon with insufficient regeneration or blood supply to the same. There is therefore an inflammatory reaction of the structures involved without typical inflammatory cells being detectable. An example of this is the runner's knee.
Tendinitis, on the other hand, is tendinitis of the knee with an acute course, such as after a one-off overloading of the affected joint. The usual inflammatory cells and markers also appear here.

A distinction must be made between two forms. At a chronic course one speaks of one Tendinosis. This is caused by long-term overuse of the tendon at the same time insufficient regeneration or blood flow the same. There is therefore an inflammatory reaction of the structures involved without typical inflammatory cells being detectable. An example of this is this Runner's knees.
At a Tendonitis on the other hand, it is a tendinitis of the knee with one acute course such as after a single overload of the affected joint. The usual inflammatory cells and markers also appear here.

causes

The cause of tendinitis in the knee is usually this mechanical overload this joint. It often affects people who are regularly very much and very much frequent sport operate without the structures being able to regenerate completely until the next training unit. But also new, unfamiliar movements or incorrect loading can cause tendinitis.
In some cases, the Sportswear be the cause of the discomfort. For example, unsuitable running shoes can cause such a misalignment that the tendons rub excessively on neighboring structures and become inflamed.
Also pre-existing illnesses on the knee joint can promote the development of tendinitis.

Cycling as a cause of tendinitis?

Although cycling is generally classified as a sport that is easy on the joints, knee pain can occur, especially after long bike tours. These can have various causes, but one of them can be tendinitis. Usually the tendon on the kneecap is affected, which connects the muscles of the long thigh extensor muscles with the knee. If this is the case, the sitting position as well as the position of the feet should be checked again when cycling in order to rule out incorrect loads. The amount of cycling should also be adjusted to avoid overloading.

Patellar tip syndrome

Patellar tendon syndrome is a disease of the patellar tendon. The transition from the tendon to the kneecap is damaged by excessive strain, resulting in painful degeneration of this transition (insertion tendinopathy).

In most cases, chronic overload is the cause of patellar tip syndrome. Therefore, athletes are most frequently affected by the symptoms, especially in running and jumping sports, but weightlifters can also suffer from patellar tip syndrome. In addition to congenital anatomical conditions (position of the kneecap and strength of the ligament structures in the knee), external influences such as the frequency of stress and the breaks in between play a major role in the development of the complaints.

Depending on the severity of the symptoms, the patellar tip syndrome is divided into four degrees of severity. In the mildest grade, the symptoms only occur after exertion, in grade two the symptoms are felt at the beginning and at the end of the exertion. Grade three is defined as persistent pain. In the worst degree, the patellar tendon is so badly damaged that it tears. Usually, the patellar tip syndrome is treated conservatively with rest, physiotherapy, anti-inflammatory drugs as well as therapeutic electrical stimulation and ultrasound. If the conservative measures fail, surgery is indicated.

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Symptoms

Usually tendinitis on the knee fails new pain on. These can also occur with a certain delay to the actual triggering movement. At the beginning they are usually only weak and kick especially when moving on. A typical feature is that they improve a little after warming up, but do not go away completely. If the tendinitis persists, knee pain can occur even at rest or even at night occur.
In some cases, a Redness or even one swelling of the joint can be observed.

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Pain in the inside of the knee

Pain on the inside of the knee can result Inflammation of the tendons running along the inside of the thigh caused. The biggest band running here is that medial collateral ligament, which is also called Inner band can be designated. It connects the muscles of the inside of the thigh (adductor group) with the inside of the shin and is partially fused with the inner meniscus. The starting point on the inside of the tibia is also called Pes anserinus designated. The different parts of the tendons radiate into these. And it is precisely these that can become inflamed under certain circumstances, which then leads to pain, especially on the inside of the knee.
The main task of the inner ligament is Prevention of excessive internal flexion in the knee joint. Sports in which precisely this function is often exhausted are above all Soccer, Alpine skiing and tennis. Excessive exercise of these disciplines can often lead to inflammation of this tendon, which can manifest itself with the symptoms mentioned above. With extreme movements, these Tendons also tearwhich, depending on the severity, can be characterized by pronounced pain Restriction of movement and a bruise with swelling.

Pain on the outside of the knee

Pain on the outside of the knee is most often caused by a Inflammation of the iliotibial band evoked. This is a tendon plate that attaches the muscles that come from the hip and run on the outside of the thigh to the thighbone just above the knee. Straight for runners this band tends to ignite. This is also called the Runner's knees or Tractus syndrome referred to and mostly arises from the combination of overuse and excessive friction between tendons and bones. Sufferers then complain of pain that is localized on the outside of the knee and above all in the usual sport occur. If the process is more advanced, these can then also in peace occur.
But also the excessive irritation of the lateral collateral ligament (Outer ligament) can cause pain on the outside of the knee. It connects muscles of the outside of the thigh with the outside of the fibula and has the function of a excessive outward flexion to prevent in the knee. In contrast to the inner ligament, this is not fused with the meniscus.

diagnosis

As is usually the case in medicine, a detailed consultation with a doctor is of decisive importance in the case of tendinitis of the knee. The beginning, the course and the character of the pain symptoms give the doctor groundbreaking information for further diagnosis. In addition, the physical examination and various movement tests determine the exact localization of the pain in order to determine the affected ligament or tendon. In some cases, magnetic resonance imaging of the knee joint (MRI for short) can also be helpful in order to better assess the exact extent of the injury. This method is particularly suitable for the visualization of soft tissues such as ligaments, tendons or parts of the joint capsule.

therapy

Treatment of tendinitis of the knee consists primarily of protecting the affected joint. Since the cause of this clinical picture is usually the overload, it has a little effect Protection and Immobilization usually an acute improvement in the pain symptoms. Additionally can also cooling compresses bring about symptom relief. If there is an acute inflammation, it can also be taken anti-inflammatory drugs such as Ibuprofen or Diclofenac be useful. The local application of these substances as ointment is conceivable. The mechanical stabilization of the tendon from the outside can be achieved, for example, by a compressive bandage or splint respectively. And last but not least, the Elevation remedy the affected knee.
The common tendinitis of the knee speaks in this way conservative treatment mostly very good. After a few days, when the pain symptoms improve, slowly begin again with gentle exercise units or physical therapy started to restore full mobility to the knee. Also Stretching exercises are particularly suitable in this phase.

Cooling or warming?

Tendonitis on the knee should be cooled immediately after the symptoms start. This reduces the body's inflammatory response, thereby relieving pain and also counteracting severe swelling. In addition, the leg should be put up. A compression bandage can also be used against the swelling.

In the course of the healing process, the effects of heat applications also increasingly come into play. The warmth relaxes the muscles, stimulates blood circulation and thus the metabolism in the muscles. In this way, inflammatory defects in the tendons can be better healed by the body.

Physiotherapy as part of the treatment

In the context of tendinitis of the knee, physiotherapy is particularly useful if the causes of the disease are in a Incorrect load or incorrect movement sequences lie. Those affected can then learn how to specifically avoid them in order to prevent renewed tendinitis. But also in general, physiotherapy is gradual for them Regaining full range of motion suitable in most cases after tendinitis.

Medicines used to treat tendinitis

In acute pain, taking pain reliever medication can improve symptoms. It makes sense to prefer to take those that also have an anti-inflammatory effect. For example, ibuprofen or diclofenac are well suited for this. As an alternative to the tablet, these can also be applied locally as an ointment or gel or even administered as a suppository.

Taping

Taping the knee can be used as a therapeutic measure for tendinitis.

A supportive tape bandage is recommended, especially at the beginning of the symptoms. This significantly relieves the affected tendon, and the tape can also have a certain compressive effect, so that swelling can be prevented. In the course of the therapy you should switch to the elastic kinesiotape. This is placed over certain muscle groups in such a way that it supports their pull. This puts less strain on both the muscles and the associated tendons.

Homeopathy for the treatment of tendinitis

Homeopaths recommend if you have tendinitis in the knee various substances, depending on which component of the complaint is in the foreground. For example, different substances are recommended for stiffness, pain, localization of the tendinitis and the cause and course of the event.

Home remedies

In the case of tendinitis on the knee, various home remedies are suitable for alleviating the symptoms.

First of all, you should use cooling agents. These include the simple cold pack and the ice pack. But cabbage or quark wraps can also be used for cooling. Due to their moisture, they require less cold to produce the same cooling effect and are easy to manufacture. In addition, cooling compresses can be soaked in apple cider vinegar, for example. This can also develop its anti-inflammatory effect.

After a while, warmth usually does better than cold for the tendinitis. Here, too, home remedies are easy to use. For example, you can put a hot water bottle or a cherry stone pillow on the affected muscle and thus promote blood circulation and metabolic activity. Rubbing in with horse ointment or rubbing alcohol can also stimulate blood circulation.

Moor balm packs can also invigorate the muscles, at the same time they have a relaxing effect and thus reduce the pressure on the inflamed tendon. You can leave wraps with Retterspitz on overnight. All home remedies should be used in combination with protecting the affected knee.

Read also: Home remedies for tendinitis

forecast

Most patients with knee tendinitis can look after a few weeks resume their sporting activities as usual. After about three months, full mobility and resilience is usually restored. Lighter and gentler training units are usually possible again after about a month. It is always important that one Rest phase strictly adhered to becomesin order to give the overloaded tendon time to regenerate and avoid permanent damage.