Knee tendinitis: Symptoms & Treatments

Knee tendinitis

Knee tendinitis is the most common tendinopathy affecting the knee. They generally occur after excessive or repeated solicitations, in particular within the framework of certain sports practices, or following a trauma of the knee. Usually, local treatment, combined with drug treatment, and followed by rehabilitation will remove knee tendinitis (pain and inflammation). In the most severe forms, immobilization or even surgery may become necessary.

Definitions and Symptoms of Knee Tendinitis

What is knee tendinitis?

Tendonitis is inflammation of the tendons in the knee. The knee joint is one of the most complex joints in the human body because it has to support the weight of the body while allowing movement. It can be subdivided into three sub-articulations:

These joints which involve three different bones, the femur, the tibia and the patella, also include a number of ligaments and tendons. Tendons are the link between a bone and a muscle and thus contribute to muscle strength. They are fibrous structures, white, resistant, more or less elongated, cylindrical or flattened, located at the end of a muscle or a muscle group. The knee joint mainly consists of the following tendons:

  • The patellar tendon;
  • The quadriceps tendon;
  • Crow’s feet tendons (on the side of the knee).

Tendons can be affected by different conditions, which specialists call tendinopathies:

  • tendinitis which corresponds to inflammation of the knee;
  • Tendon ruptures, following trauma;
  • Tenosynovitis, which affects the envelope of the tendon.

Knee tendinitis can affect either the body of the tendon itself or its insertion into muscle or bone (insertion tendonitis). Usually tendonitis occurs on one side only (unilateral), but sometimes it can affect both knees.

The tendon is an anatomical formation interposed between the muscle and the bone. It is in fact the fibrous end, white and resistant, more or less elongated, cylindrical or flattened, of a muscle or of a muscular belly.

Tendinopathies, the first of which is tendonitis, are frequent ailments, and the most common tendonitis is patellar tendonitis. The practice of certain sports, such as cycling or skiing, can increase the incidence. In practice, the causes of knee tendonitis are generally:

  • Excessive and repeated stress on the knee;
  • Excessive and sudden tension in the tendons of the knee;
  • Shock or trauma to the knee;
  • The friction of the tendon on another joint structure, for example a protruding bone.

To know ! In children, particular forms of tendonitis can develop during growth, in the event of excessive strain on the tendons. If these stresses are repeated regularly, abnormal bone formations can develop.

Interesting to learn: What Is Sinus Tarsi Syndrome? Symptoms, Diagnosis, and Treatment

What symptoms?

The main symptom of knee tendinitis is knee pain, which is often strong and persistent. Depending on the case, the pain can:

  • Occur after sport;
  • Disappear at rest;
  • Persist at rest;
  • Remain constant whatever the activity;
  • Become chronic and disrupt daily activities.

Along with pain, knee tendonitis manifests itself with characteristic signs of inflammation in the joint:

  • Redness of the joint;
  • A heat;
  • Swelling of the joint.

If the origin of the tendonitis does not go away, the pain and inflammation persist and can become chronic.

Diagnosis and treatment of knee tendinitis 

What diagnosis?

Tendinitis, by the pain and functional discomfort that they cause generally leads the patient to consult after a few days or a few weeks. The doctor begins by questioning and examining the patient to define:

  • The characteristics and intensity of pain;
  • The circumstances of the occurrence of tendinitis;
  • The general state of health of the patient.

To confirm the diagnosis, the doctor may order additional tests, including:

  • An x-ray of the knee;
  • An ultrasound of the knee;
  • An MRI (Magnetic Resonance Imaging) of the knee, the most precise imaging examination currently available to reveal inflammation of the tendons and to identify the affected tendon.

What treatments?

In the face of knee tendinitis, complete rest of the joint has long been the first treatment. As with other osteoarticular disorders, complete rest is no longer considered today as an effective therapeutic solution for inflammation of the tendons. This is because complete rest can lead to a reduction in the mass of the muscles in the joint. At complete rest, a reduction in stress for a while, followed by a gradual and controlled resumption of activities, especially sports, are now recommended.

Along with this reduction in physical activity, several treatments may be considered depending on the affected tendon and the nature of the tendonitis:

  • A strapping (contention technique more or less flexible, as implemented by the intersection of several specific bands, and which limits the movements of the joint and thus the stresses of inflamed tendons);
  • Wearing a knee brace , intended to block the knee joint;
  • Canes or crutches to avoid resting the weight of the body on the knee in pain.

Along with these local non-pharmacological treatments, drugs may be prescribed to reduce knee pain:

  • Anti-inflammatory drugs and more particularly non-steroidal anti-inflammatory drugs, either administered locally (gels, patches), or administered orally;
  • Local infiltration into the knee joint of corticosteroid drugs to reduce inflammation;
  • Mesotherapy (injection of low doses of drugs (often combining anti-inflammatory drugs, a vasodilator and an anesthetic).

After the phase of partial resting and blocking of the joint, the rehabilitation phase is essential to restore the full functionality of the knee joint and prevent the recurrence of tendonitis. 

Rehabilitation, adapted to the case of each patient, can implement different techniques:

  • The physiotherapy  (massage);
  • Physiotherapy (application of ultrasound, an analgesic current or a laser);
  • The electrostimulation  ;
  • Stretching techniques.

In the most severe forms of knee tendinitis, these different therapies may be ineffective or insufficiently effective. Immobilization may then be necessary over a period of 3 to 4 weeks. A cast is then placed around the knee, going up to the thigh and down to the foot. Surgical intervention may be essential and may consist of different interventions:

  • Lengthening of the affected muscle;
  • Disinsertion of the tendon and resting of the muscle and tendon;
  • Denervation;
  • A cleaning of the tendon and the articular zone;
  • Removal of damaged areas of the joint;
  • Combination of the tendon (longitudinal incision of the tendon in several parts to separate the tendon fibers without damaging them).

In these more severe forms, complete rehabilitation of the tendon can be long (several months).

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