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Knee tendonitis symptoms

28 Jun 18

Tendinitis of the knee joint

Human feet are exposed to a lot of stress every day, so it is not surprising that many people begin to complain of pain and discomfort. Knee tendonitis is an inflammation that occurs in the connective tissue and affects the patellar ligament. Often the disease develops against the background of systemic diseases.

According to statistics, tendon inflammation is a common disease among representatives of the stronger half of humanity. Because it occurs during excessive sports or heavy physical labor. Let's talk in more detail about tendinitis, what it is, the causes of its occurrence and the features of treatment.

Tendonitis is caused by many factors. We invite you to familiarize yourself with the most common of them.

High activity during sports is one of the causes of tendinitis. The tendon involved in performing monotonous work is injured. The muscle tissue contracts and stretches the tendon; jerking and exercising without prior warm-up pose a danger. With constant microtraumas, tendonitis of the knee joint, Achilles tendon or hip is diagnosed.

They are microscopic damage to the collagen fibers that form the tendon. This process most often occurs at the junction of bone and tendon. This is why a person feels pain in the area of ​​large joints. The connective tissue is very strong, so the small muscles cannot contract so strongly as to tear the tendon.

Inflammation of the Achilles tendon

They can be provoked by infectious diseases - gonorrhea, some staphylococci, borreliosis, chlamydia, syphilis and some viral microbes. The mechanism of infection is simple - pathogenic microorganisms spread through blood and lymph. The body begins to fight the infection, and since bacteria accumulate in the joint area, an acute inflammatory process begins there. Therefore, you should remember that a pathogenic microorganism is unable to independently cause tendonitis.

Diseases of a rheumatic nature that are hereditary or acquired. They require a special approach to treatment.

Weakened immunity. Pathogenic bacteria, not meeting resistance, begin to actively multiply, and often provoke inflammation of the tendons. Tendonitis of the knee joint can be caused by acute respiratory viral infections, chemotherapy for cancer, diseases of the hematopoietic system, the use of drugs with corticosteroids, and even long-term use of antibiotics.

Autoimmune diseases - antibodies are produced that perceive connective tissue as a foreign agent and begin to fight it. In this case, inflammation of the tendon accompanies the person throughout his life.

Metabolic disease. Refers to tendonitis, which is caused by gout.

Symptoms of joint tendinitis are as follows:

  • Painful sensations in the joint area. If the cause of the disease is an injury, the pain is sharp and occurs when the tendon fibers rupture. Subsequently, the patient complains of discomfort only during physical activity.
  • Decreased physical activity. Microtrauma leads to swelling, which causes the tendon cord to glide poorly. This leads to a limitation in the range of movement.
  • Formation of nodules. Upon palpation, a specialist can detect compactions. If the cause of tendonitis is an injury, then it is an overgrowth of fibrous tissue. The seal has a diameter of several millimeters and moves when the muscle is tense. Sometimes calcium salt is deposited in the node and it becomes hard. Please note that fibrous nodes can resolve on their own, but calcifications do not, and they cause severe pain.
  • Rarely - redness of the skin at the tendon site.
  • Auscultatory noise is possible with fibrous nodes or calcifications.
  • Tendinitis of the lower extremities is mainly diagnosed in the feet. The Achilles tendon and big toe are affected, and the tibialis posterior muscle and arch of the foot may also be affected. Patients complain of painful movement of the foot. This disease often develops in track and field athletes and women who prefer high-heeled shoes. Achilles tendonitis can lead to an osteophyte (spur).

    Tendons of the knee joint - provoked by jumping or high load on the knee. The symptoms of the disease are similar to a sprained joint, so differentiated diagnostics will help identify tendinitis. With timely treatment, the prognosis is favorable, and the patient notes an improvement in condition after 3 days. A complication is aseptic necrosis of the tibia tuberosity.

    Inflammation of the thigh muscle tendons

    Inflammation of the femoral tendons is a collective concept because it is characterized by changes that occur in the joints located near the hip. A competent specialist will recognize where the inflammation is based on the symptoms:

  • Adductor muscle – complaints of pain when abducting the leg. Limb movements are limited.
  • Abductor muscle – outer thigh hurts.
  • Iliopsoas muscle - discomfort throughout the thigh, pain radiates to the lower abdomen. Making a diagnosis is problematic because the symptoms are similar to other diseases.
  • Inflammation of the tendon apparatus of the hip joint can lead to disability if not treated in a timely manner.

    The diagnosis of Achilles or patellar tendonitis can be made by examining the affected joint and taking a medical history.

    During the examination, the specialist checks:

  • How symmetrical joints work.
  • Is there pain during active movement?
  • Does the patient feel pain when palpating the tendon area?
  • Is there a history of serious trauma?
  • Additionally, a specialist can prescribe laboratory tests, as well as instrumental diagnostics.

    A treatment regimen for tendinitis is selected only after the cause has been identified. If the tendon damage occurs after an injury, then the patient is treated at home. For inflammation of the femoral tendons, patella and or Achilles tendon, which is diagnosed against the background of another disease, therapy is selected to eliminate local symptoms.

  • After an injury, cold must be applied.
  • Immobilization of the leg.
  • Prescribing anti-inflammatory drugs.
  • Physiotherapy.
  • Lotions or a cold compress are used in the first 3 hours after injury. The cold helps the capillaries constrict and reduce blood flow to the injured area, which will reduce swelling. Achilles or knee tendonitis caused by a systemic disease does not require the use of cold packs.

    This method is required for effective therapy. Because it allows you to relax the muscles and not stretch the inflamed tendon. During acute inflammation, the traumatologist may apply a cast for 2-4 weeks.

    If Achilles tendinitis is diagnosed against the background of rheumatic diseases or gout, then immobilization is not performed. The patient should reduce the load on the sore area.

    Anti-inflammatory

    This group of medications eliminates inflammation of the tendons of the hip joint, as a result, swelling subsides and pain subsides. Therapy does not exceed 14 days. The main criterion for recovery is the absence of pain and restoration of range of motion.

    Treatment of inflammation of the Achilles tendon, knee and hip should only be carried out under the supervision of a specialist. Because in some cases it is necessary to adjust the treatment regimen. Typically, non-steroidal anti-inflammatory drugs are prescribed, for example, Ibuprofen, Diclofenac, Nimesulide, or corticosteroids, for example, Hydrocortisone.

    Physiotherapy procedures for the knee joint can speed up the tissue healing process by accelerating metabolism. Use:

    Thanks to comprehensive treatment, tendinitis can be quickly cured. The positive therapeutic effect will last for a long time if you adhere to preventive measures and do not overwork the joints.

    Knee hurts - it could be tendonitis

    Knee movement and stability are possible thanks to the coordinated work of its five ligaments:

  • two cruciform,
  • two lateral
  • own patellar ligament.
  • In addition to the unpleasant situations associated with direct injury to the knee (torn ligaments, dislocation or fracture), another danger arises - tendonitis of the knee joint (inflammation of the tendons and ligaments). The most common diagnosis is tendonitis of the patellar tendon.

    Anatomy of the patellar ligament

    The ligament proper continues the quadriceps femoris tendon and attaches it anteriorly to the tibial tubercle located below the kneecap.

    This original structure makes the knee joint unique: it provides not only motor functions, but also works on the principle of a lever-and-block mechanism, multiplying the efficiency of the quadriceps muscle:

    The patella itself can be considered a block, and its own ligament can be considered a long arm of a lever.

    Causes of knee tendonitis

    Knee tendonitis is caused by either mechanical or degenerative causes.

    Tendinitis of mechanical origin

    The first type (mechanical) is associated with sports or professional activities:

  • Constant training or stress leads to microtrauma of the ligament and the occurrence of an inflammatory process in it.
  • Patellar tendonitis is most often diagnosed in athletes involved in jumping sports, which is why this pathology has received a very accurate name - jumper's knee.
  • The greatest tension always appears at the place of attachment of the ligament, and, consequently, tendonitis develops mainly at the place of its fixation to the patella or the tibial tubercle (the first is more common). Thus, it is more appropriate to consider it not tendinitis, but enthesitis.

    Precipitating factors for tendinitis are:

  • flat feet with the foot falling inward (pronation);
  • the anatomical position of the kneecap, in which the ligament is pinched by it when the knee is bent above 60°;
  • impaired knee stability with rotation of the femur and tibia;
  • Hamstring syndrome - injuries due to constant stress on the muscles of the back of the thigh.
  • Degenerative tendinitis

    The second type of tendinitis is age-related and is associated with aging of the ligaments and degenerative changes in them:

  • mucoid process or fibrosis predominates;
  • pseudocysts appear.
  • Ligament degeneration can be caused by:

    • rheumatoid arthritis;
    • infectious arthritis;
    • diabetes;
    • long-term use of glucocorticosteroids and other reasons.
    • In a weakened ligament, the process of regeneration simultaneously occurs - the restoration of degeneratively changed areas:

    • restored areas are denser and larger;
    • angiofibroblastosis is possible in them;
    • Ossification (ossification) and calcification of the ligaments may occur, a feature seen in both types of tendinitis.
    • Stages of knee ligament tendinitis

      Knee tendinitis goes through four stages:

    • The first is that symptoms of discomfort and pain occur only after training or exertion.
    • Secondly, the above symptoms are possible both before and after the load.
    • The third is pain symptoms during the exercise itself and after it.
    • The fourth is a ligament rupture.
    • The rupture occurs naturally: chronic inflammation in the ligament leads to its structural changes, reducing mechanical strength. If the rupture did not occur due to a normal injury, but due to tendonitis, then it is considered a complication of tendonitis.

      Symptoms of knee tendonitis

    • Tendonitis of the patellar tendon begins initially with mild, dull pain in the lower part of the kneecap or in the area of ​​the tibial tubercle.
    • At an early stage, pain occurs mainly after exercise.
    • There may also be a feeling of tension or stiffness, and it may be difficult to straighten the knee.
    • As the pain progresses, it becomes more intense until it begins to accompany all flexion and extension movements.
    • If tendinitis affects the deep layers, then with strong and deep pressure on the area between the kneecap and the tibial tubercle, pain occurs.
    • A symptom of partial or complete ligament rupture is pain when extended with resistance.
    • To clarify the diagnosis, an x-ray of the knee is taken: frontal and lateral projection.

      X-rays can reveal fatigue microtraumas, areas of ossification and calcification.

      Please note that knee pain can occur for many reasons:

    • damage and rupture of the meniscus;
    • osteochondropathy of the patella;
    • enlarged tubercle of the tibia.
    • Closer examination of localized areas of the ligament or meniscus may require precise examination using computed tomography or magnetic resonance imaging.

      Knee tendinitis: treatment methods

      In the first two stages, conservative treatment is used:

    • They facilitate training and load regimes, reducing the intensity of training or work.
    • Ice compresses are applied.
    • To reduce pain, non-steroidal anti-inflammatory drugs (ibuprofen, indomethacin, naproxen) are used orally or intramuscularly.
    • It is better not to use intra-articular local injections of NSAIDs or glucocorticosteroids for knee tendonitis, as they contribute to the development of ligament atrophy.

      All these drugs give a temporary effect and have many side effects, especially for the gastrointestinal tract.

      The main method of treating knee tendonitis is exercise therapy with exercises for hyperextension and strengthening of the quadriceps and posterior muscles.

      They take a long time to perform (sometimes several months), but the effect of the exercises is very good - they allow you to cure tendinitis and resume training or work in full mode.

      Another type of conservative non-drug treatment is taping.

      Taping for knee tendinitis

      The point of taping is to use special tapes that relieve the ligament.

      There are different types of taping:

    • the tape is glued across the ligament;
    • cross-shaped with fastening at the top or bottom;
    • along the ligament with fixation below the tibial tubercle, to which the patellar ligament is attached;
    • combined taping (for example, cruciform and longitudinal, cruciform and transverse).
    • Just like taping, wearing orthoses helps to relieve the knee ligament, but it is not placed directly on the kneecap, but a little lower.

      Surgery

      Tendonitis of the knee joint of the third or fourth degree is difficult to eliminate conservatively, and then surgical treatment may be required.

      Arthroscopy is often used, a method in which an instrument is inserted through small punctures under the supervision of a microscopic video camera and the damaged areas are removed. In this way it is possible to delete:

    • minor ligament damage;
    • growths on the kneecap if they impinge on the ligaments.
    • Cysts and other formations require open surgery.

    • excision of the ligament;
    • scraping the lower part of the kneecap;
    • multiple tenotomies on ligaments (notches).
    • But these methods can lead to weakening and rupture of the ligament in the future. At the fourth stage, the preferred operation is plastic reconstruction.

      Sometimes surgeons resort to other types of operations:

    • resection of the lower pole of the patella, if it is considered to be the culprit of chronic knee tendonitis;
    • removal of the fatty body (Hoffa) located under the patella.
    • Exercise therapy: examples of exercises for knee tendonitis

      These exercises are very effective for knee tendinitis:

      Quadriceps stretching exercises:

    • Turning your back to the table or cabinet and holding the back of the chair, place your right leg on the table. We maintain balance for 45 - 60 seconds, feeling the tension on the front surface of the thigh. We repeat the exercise with the left leg.
    • You can slightly modify the exercise by not placing it on the table, but holding the foot from behind with your hand.
    • Sitting on the floor, lean back, leaning on your elbows behind you. We bend one leg at the knee, and raise the other straightened and hold it for some time. Then change the position of your legs and repeat the lift.
    • Isometric exercise (for severe pain):
      • Sit on the floor with your legs straight, hands resting on the floor behind you.
      • Tighten the leg muscle, pulling the kneecap towards you (the leg remains motionless).
      • Hold this position for a few seconds, then relax and repeat with the other leg.
      • Perform 20 times in several approaches.
      • Resistance exercises (performed with a resistance band or resistance band):
        • The leg bent at the knee is fixed with tape. We straighten the knee, overcoming resistance.
        • Other options: moving the leg back with resistance, to the side, swinging the leg.
        • Exercises for the posterior thigh muscles:

        • While standing in front of a table (gymnastic ladder), place your foot on the surface or bar and reach with your hands towards your foot without bending the other leg.
        • While sitting on the floor, bend alternately towards the feet of your spread legs.
        • Video: Self-healing knee tendinitis.

          Knee tendonitis: knee treatment, symptoms of tendon inflammation

          Tendinosis is an inflammation of the connective tissues of the joint where the tendon attaches to the muscles and bones. Knee tendonitis is an inflammation of the patellar tendons. In this case, the ligaments of the tibia and quadriceps femoris are affected.

          Most often, inflammation begins at the junction of the tendon and bone. Knee tendonitis occurs with approximately the same frequency in both men and women. The risk group includes:

        • Professional athletes, participants in outdoor games - volleyball, basketball or football;
        • Active children and teenagers;
        • People who have crossed the forty-year mark;
        • Workers whose activities involve heavy daily loads on the knee joints.
        • The patellar tendons are responsible for flexion-extension movements and raising the outstretched leg. Most often, tendinitis of the knee joint affects the lower limb that is pushing, and only in rare cases does inflammation develop on both limbs at once.

          This is explained very simply: under load, tendons and ligaments receive microtraumas, but if they are given sufficient rest, the tissues have time to recover. If there is little rest, and the loads are regular and intense, microtraumas do not heal.

          Degenerative changes in the tendons occur and inflammation begins. Such injuries are called fatigue injuries.

          Sometimes, for tendonitis of the knee joint to develop, it is enough just to constantly leave the limb in uncomfortable conditions.

          Clinical picture of the disease

          Inflammation of the patellar tendons can be acute or chronic. According to the nature of occurrence, acute tendinitis in the patella area is:

          Chronic patella disease is classified into:

          1. Fibrous or ossifying.
          2. Developed due to the accumulation of salts.
          3. In any case, microtrauma to the ligament leads to its weakening. As a result, partial or complete rupture of ligaments and tendons occurs.

            Causes of tendonitis:

          4. Patellar injuries of varying severity;
          5. Exceeding permissible loads;
          6. Bacteria or fungus;
          7. Allergic reactions to certain medications;
          8. Joint diseases - gout, arthrosis, rheumatoid arthritis;
          9. Congenital pathologies - different lengths of limbs, flat feet;
          10. Incorrectly selected shoes;
          11. Incorrect position when sitting or walking;
          12. Weakened immunity;
          13. Intestinal parasites;
          14. Age-related changes in joint tissues;
          15. Instability and hypermobility of the patella.
          16. The factor or combination of factors that provoked the development of tendonitis determines how the treatment will be carried out.

            The reasons listed are the most common. But it is not excluded that the impetus for the formation of tendonitis of the knee joint can be diseases of an autoimmune nature, pathologies of the endocrine system, and renal failure.

            Tendinitis has signs characteristic of any inflammation of the joints. This is, first of all, pain when moving, changes in weather conditions, stiffness in the knee joint and limited mobility of the limb. On palpation, the joint is very painful; if you ask the patient to bend the leg, a crunching or squeaking sound may be heard.

            Visually, the joint is enlarged, swelling and redness are noted. Pain can occur suddenly with the most ordinary movements - squatting or getting up from a chair, climbing stairs.

            This symptom significantly complicates the patient’s usual life, disrupts his activity, reduces his ability to work and excludes him from playing sports.

            In order to make a diagnosis, it is enough to carefully examine the diseased joint and palpate it.

            Tendinitis, regardless of the nature and nature of its occurrence, always develops and occurs in several stages. At the initial stage, the patient does not feel any particular discomfort, pain occurs very rarely, and mobility is not impaired. The reason is large, long-term loads.

            When the disease moves to the second stage, pain appears in paroxysms and can overtake the patient even when performing normal tasks or sports training. In the third stage, the pain intensifies. And at the last stage, damage occurs to the largest bone of the skeleton - the sesamoid.

            Treatment is different at each stage and may vary depending on the dynamics of the disease and the patient's condition.

            How is the treatment carried out?

            In the first three stages of tendinitis, treatment with conservative methods can be quite successful. First of all, you need to relieve the affected joint from stress. For this we use:

          17. Supportive orthopedic devices – crutches, canes;
          18. Rigid fixing bandage for the knee pad - a plaster splint or a special orthosis, a knee pad for the knee joint.
          19. Sometimes tapes can replace an orthosis - thick adhesive tapes that fix the knee joint, but at the same time do not limit the mobility of the leg too much.

            With the help of such orthopedic devices, it is possible to treat an already developed disease, or to prevent it if the limbs are constantly exposed to heavy loads in the work process or during regular sports training. Complex treatment necessarily includes massage.

            Drug treatment is based on taking drugs from the group of non-steroidal anti-inflammatory drugs. To eliminate the causes of the disease, tablets or powders are prescribed for internal use or medications in liquid form for injection, including intra-articular ones.

            External agents - ointments, gels, creams - with similar active substances can quickly, but not for long, relieve local symptoms. They are used as auxiliary in general therapy.

            Nonsteroidal anti-inflammatory drugs effectively eliminate pain and inflammation, but treatment with them should not exceed two weeks. Otherwise, serious damage to the digestive system occurs, primarily to the gastric mucosa.

            If treatment with such drugs does not bring the expected result within 14 days, they are stopped and treatment with hormonal drugs is started. Corticosteroids are administered intra-articularly, often combined with plasma injections. This treatment is effective even with very severe pain and damage to the knee.

            As soon as the patient's condition has improved, treatment with corticosteroids is stopped - hormones greatly weaken connective tissues, which can cause them to rupture. Plasma, on the contrary, contains platelets and promotes rapid tissue regeneration.

            Tendonitis of infectious origin is treated with antibiotics. They are also prescribed in tablet form or administered by injection.

            Drug treatment is always complemented by physiotherapy. To enhance the effect of medications, the following are usually prescribed:

            Therapeutic exercises for tendonitis help strengthen the ligaments and maintain mobility of the knee joint. Performing physical therapy exercises is mandatory when drug treatment is completed and the recovery period has passed.

            Surgical treatment is necessary if ligament rupture occurs in the advanced stage of the disease. Two methods of performing the operation are used: arthroscopic and classical (with dissection of the soft tissues of the knee joint with a scalpel). Arthroscopy is preferable; this method is less traumatic and recovery is faster.

            But arthroscopy is not always effective. If the growths on the knee joint are extensive, if a cyst has formed, they can only be removed during surgery using the classical method. In some cases, to stimulate the regeneration of joint tissue, the surgeon performs curettage of the lower part of the kneecap.

            Surgery is necessary if there is narrowing of blood vessels or pinched ligaments. Recovery takes about 3 months.

            How to cure knee tendinitis?

            Knee tendonitis is an inflammation that occurs in a tendon or joint, causing external redness or swelling. This condition may cause pain or weakness in the affected area.

            The development of the disease can be observed at any age. But mostly people over the age of 40 suffer, as well as those who engage in physical activity or stay in one position for a long time.

            With chronic overload, the first reaction is swelling of the tendon, accompanied by microscopic breakdown of collagen and changes in the mucous membrane near the inflammatory area.

            Mostly, the area of ​​inflammation occurs at the joints of bones and ligaments, but sometimes the process spreads throughout the tendon. Chronic tendinitis can develop as a result of regular weeds.

            For what reasons does the disease develop?

            There are many causes of knee tendinitis, the main ones being:

            — Infection with bacteria and fungi;

            — Long-term loads on the knee joints;

            — Numerous microtraumas and damages;

            — Joint diseases such as rheumatoid arthritis, arthrosis deformans or gout;

            — Incorrect posture and body structure (presence of flat feet, etc.);

            — Allergies when taking certain medications;

            — Wearing uncomfortable shoes;

            — High mobility and instability of the knee;

            — Changes in tendons that occur with age;

            - Muscle imbalance.

            Based on the cause of the disease, infectious and non-infectious tendinitis are distinguished.

            Determining the specific cause of the disease is a major factor in proper treatment, which can lead to prompt recovery.

            The main symptom of the disease is limited movement and pain that occurs in and around the area of ​​inflammation, associated with intensity and mobility.

            The pain may appear suddenly, but often it increases in accordance with the inflammatory process. There is also high sensitivity when palpating the inflamed tendon.

            Symptoms of knee tendonitis include the appearance of a creaking sound that occurs when the limb moves. also occur .

            There are temporary manifestations of pain as a result of palpation or movement, which are localized in the damaged area.

            Complications of knee tendonitis can occur when calcium accumulates, as this causes weakening of the tendon and joint capsule.

            Patients experience difficulty going up or down stairs, running, and walking.

            Tendinitis develops sequentially, so the following stages of its manifestation are distinguished:

            — The appearance of pain after significant exertion;

            — The occurrence of paroxysmal pain during low and standard loads after classes and work activities;

            — Manifestation of intense pain even during rest;

            — The patellar ligaments may rupture due to the progression and advanced form of the disease.

            Carrying out diagnostic studies

            At the initial stage of diagnosing tendonitis, the affected area is examined by palpation. It is very important to correctly differentiate tendonitis from other pathologies.

            To clarify the diagnosis, the following examination may be prescribed:

            The doctor observes changes that may occur due to infection or rheumatoid arthritis;

            Computer and magnetic resonance imaging helps to identify ruptures and changes in tendons that require surgical intervention;

            The result of an X-ray examination determines the last stage of the disease, the cause of which was excess salts, as well as arthritis or bursitis;

            They can be used to determine changes or narrowing of the structure of the patellar tendon.

            An appropriate examination determines the symptoms and stage of the existing knee joint disease, identifying the damaged area and inflammation.

            Laboratory research involves the analysis of biological materials from the patient. This includes a blood test.

            In this case, leukocytosis, increased uric acid volume, and the presence of C-reactive protein may be detected. In addition, a study of the joint fluid can be done (to detect gout).

            Treatment and restoration of the knee joint

            Currently, there are the following treatment methods for determining knee tendonitis:

            — Physical culture of a therapeutic nature;

            — Traditional medicine methods;

            To treat stage 1-3 tendonitis, conservative methods are used.

            First of all, the load on the affected joint is limited or it is immobilized.

            To reduce the load on the damaged patella, crutches or a cane are used, and immobilization measures include the application of a plaster cast or splint.

            A complex of medications and physiotherapy is also used.

            If the disease progresses unfavorably, surgical therapy is prescribed.

            To reduce the load on the patella, an orthosis or taping is used (attaching special tapes or tapes to the damaged knee).

            Orthoses are an effective way to treat knee tendonitis and can be recommended as a preventive measure during training or fitness.

            Drug therapy

            Doctors recommend drugs with anti-inflammatory and non-steroidal analgesic effects (Ketoprofen, Ibuprofen, Indomethacin, Naproxen, Piroxicam, etc.).

            The drugs eliminate the process of inflammation and pain, but do not lead to complete recovery. Doctors prescribe medications in the form of external agents (creams, ointments, gels) and internal injections.

            Long-term use of nonsteroidal drugs can negatively affect the gastric mucosa, which is why they are prescribed for only 2 weeks. If such drugs are ineffective, injections of corticosteroids and platelet-rich plasma are recommended. Corticosteroids relieve pain, but overuse can weaken the tendons.

            For severe inflammation of infectious tendinitis, antibiotics and antibacterial agents are recommended.

            The following physiotherapeutic methods have a positive effect in the treatment of tendinitis:

            A therapeutic and physical set of exercises may be prescribed to stretch and strengthen the knee muscles, after which the tendons are restored.

            Physiotherapy

            Of particular importance in therapy and preventive measures for stage 1 and 2 tendinitis is physical therapy designed to stimulate and stretch the 4-head muscles (quadriceps).

            The duration of treatment can be several months, after which you can begin training and exercise.

            Therapeutic exercise consists of the following manipulations:

            — Extraction of the 4 head muscles;

            — Stretching the hamstring muscles;

            — Raising the legs to the side in a lying lateral position;

            — Knee extension with resistance;

            — Raising a straight leg while lying on your back;

            — Raising your legs to the side while in a lateral position;

            — Squeezing the ball with your knees, while your back should be pressed against the wall;

            - Walking or swinging your legs against resistance;

            - Isometric muscle resistance, knee bending in a sitting position.

            After eliminating pain, doctors recommend that professional athletes do platform squats.

            In case of partial tear or complete rupture of the knee tendon at the 4th stage of tendinitis, surgery is prescribed. In this case, the affected tissue in the area of ​​the patella is removed using open (with a regular incision) or arthroscopic (endoscopic surgery) surgery.

            If a bone growth appears on the patella with pinching of the ligaments, it is removed arthroscopically (through tiny incisions).

            Existing cysts and other degenerative changes on the ligaments are removed openly.

            In some cases, along with excision of the altered tissue, the lower zone of the patella is scraped, which helps to activate inflammation.

            In the later stages, the ligament is reconstructed to restore the functions of the 4th femoris muscle.

            According to many experts, it becomes mandatory to reduce the lower pole of the patella.

            During surgery, the Hoffa fat pad can be completely or partially removed and transferred to the area where the ligament attaches.

            The postoperative period lasts 2-3 months.

            This therapy eliminates pain and inflammation under external and internal influences.

            The simplest method is rubbing with pieces of ice, using Turmeric seasoning, drinking tincture of walnut partitions, heating with wheat cereal, etc.

            Compresses made from infusion of garlic, eucalyptus oil, apple cider vinegar, and grated potatoes can be used.

            In the first hours after injury, cold is used in the form of ice or lotions. At the same time, the capillaries narrow, blood supply and swelling decrease.

            Knee immobilization

            In successful treatment, immobilization of the limb, which limits joint mobility, is considered an important criterion. This allows you to avoid stretching the sore tendon.

            In case of active inflammation, a plaster cast may be applied for 2-4 weeks.

            Preventive actions

            First of all, you need to remember that before physical activity you need to do a warm-up. You should also gradually increase the pace of exercise and not work to the point of overexertion.

            If you have minor pain, you should change your activity or rest.

            To prevent the disease, you should not do monotonous work with one joint for a long time.

            Tendonitis refers to pathologies that reduce a person’s quality of life due to limited movement.

            Therefore, along with treatment, prevention should be carried out to reduce the possibility of recurrence of the disease. To do this, the muscles located near the affected tendon are strengthened.

            When inflammation of the knee causes complications in the tendons and spreads to surrounding tissues, a diagnosis of tendinosis of the knee joint is made. The disease mainly affects athletes, but it can occur in any person, regardless of gender, age and occupation. Lack of diagnosis and therapeutic measures lead to limited leg mobility and lead to the development of disability.

            Etiology and pathogenesis

            The appearance of the disease is influenced by two factors: the intensity of physical and motor stress on the knee tendons and frequent microtraumas of the joint. The lack of proper rest for the leg, during which minor injuries have time to heal and tissues to regenerate, aggravates the condition of the cartilage and joint capsule as a whole, giving impetus to the development of degenerative processes. Tendinosis can occur due to rheumatoid arthritis or gout. The following factors can also provoke the disease:

          20. bacterial and fungal infections;
          21. weakened immune system;
          22. allergic reactions;
          23. curvature of the spine and poor posture;
          24. foot deformity, flat feet;
          25. Shoes that are too tight or loose.
          26. The disease occurs during severe physical exertion and injury.

            Particularly severe forms of the disease occur in old age. The disease is often observed in hyperactive teenagers and young athletes. At risk are athletes, football players, golfers, tennis players, basketball players and other athletes whose activities involve intense stress on their legs and arms. Factory workers, builders, loaders and other people whose work involves heavy and prolonged physical labor are also susceptible to the disease.

            Types of knee tendinosis

            Depending on the cause that provoked tendinosis, it is divided into two types:

            • infectious;
            • non-infectious.
            • Depending on the area where the load falls, the following types of disease are distinguished:

            • Quervain's disease, which affects the tendons of the thumb;
            • epicondylitis of the wrist (tennis elbow);
            • degeneration of the forearm muscles;
            • quadriceps tendinosis.

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            The manifestations of the disease are similar to those of a sprained ligament, so it is necessary to accurately diagnose it for proper treatment. The first signal is pain - sharp or nagging, depending on the extent and location of the lesion. Then other symptoms appear, the severity of which depends on the severity of the injury or exacerbation of the chronic degenerative process. These include:

          27. redness and swelling of the joint;
          28. limitation of joint mobility;
          29. local increase in temperature;
          30. crunching in bones when moving.
          31. The development of the disease is divided into four stages, each of which is characterized by its own set of symptoms. Based on them, the doctor makes a preliminary diagnosis. Depending on various circumstances (sudden major injury, exacerbation of sluggish chronic inflammation), the patient may receive the disease at once 2 or 3 degrees. A brief description of the manifestations of each stage is presented in the table:

            Diagnostic methods

            Diagnosis of the disease is performed by manually palpating the anterior cruciate ligament of the knee and the joint capsule, so it is important that the manipulation is performed by a qualified specialist. To clarify the parameters of the damage, an MRI examination is prescribed. In some cases, radiography may be necessary. Images are needed to recognize complications of tendinosis, such as heel spurs, and protrusion of the head of the joint from the cartilaginous bed.

            In an advanced stage, the only way to get rid of the disease is through surgery.

            The approach to getting rid of the disease is complex. A doctor should prescribe a course and monitor its effectiveness; self-medication can aggravate the situation. Against the background of drug therapy, hardware methods are used, and knee support is practiced using folk remedies. Surgery is indicated at the last stage, when the tissues are destroyed and cannot be regenerated.

            To relieve pain and prevent destructive processes in ligaments and tendons, physical therapy is recommended. Exercises should be aimed at increasing tissue elasticity and strengthening muscles. Yoga, Pilates and stretching are suitable. Techniques from artistic gymnastics are prohibited, since it is impossible to create additional stress on the knee.

            Pharmaceutical drugs

            To treat the disease, non-steroidal anti-inflammatory drugs, such as Ibuprofen, are prescribed. The products are effective in combating pain, reducing swelling and eliminating inflammation. However, due to the negative effects on the stomach, they should be taken for no more than 14 days. If there is no proper result, a course of hormonal therapy with corticosteroid medications is carried out, which are injected directly into the knee joint. The duration of treatment is from 3 to 7 days.

            Among hardware methods, ultrasound, magnetic and electrical procedures are recommended. At an early stage, electrophoresis of the patella shows high efficiency. To maintain the elasticity of ligaments and tendons, UHF, magnetic therapy, and iontophoresis are used. All manipulations are performed in the clinic, in the physical room under the supervision of a doctor. The course of treatment and duration is prescribed by an orthopedic specialist. A sauna will help relax muscles and tendons, while mud therapy and paraffin therapy will provide tissue regeneration.

            It is permissible to treat tendinosis with traditional medicine only in the first stages of the disease. Alcohol rubs based on horse chestnut, dandelions, ointments with the addition of bee and snake venom, and red pepper are widely used. For pain, warm compresses with eucalyptus and tea tree extracts are recommended. Knee pads are worn to support the knee joint.

            Surgical intervention

            Surgery is recommended only at the last stage of the disease, when the joint tissues are irreversibly destroyed. The damaged parts are removed by an open incision or arthroscopic method, and the lower part of the patella is scraped off. After the operation, the patient needs rest for a long time and the use of agents that restore tissue, which actually slowly grows back.

            The best way to avoid developing tendinosis is to avoid excessive movement and physical activity. During regular sports or physical work, joints should be supported with bandages, relieving tension in the joints and protecting muscles and tendons from micro-tears. It is important to treat inflammatory processes, because as a complication you can get degenerative pathology in the knee, wrist or ankle.

            Signs of knee tendonitis and how to treat it

            Tendonitis of the knee joint is an inflammation of the tendon, characterized by severe pain and deterioration in the mobility of the joints. Most often, the disease develops as a result of traumatic damage to the ligaments, which provokes the occurrence of an inflammatory process, as well as under the influence of pathogenic and opportunistic microorganisms that penetrate through the bloodstream from chronic foci of infection.

            The clinical manifestations of the disease depend on which part of the tendon is damaged. Most often, the patellar ligament itself is damaged, resulting in the development of “jumper’s knee.” The name is due to the fact that the disease is mainly registered in athletes: volleyball players, tennis players, football players, track and field athletes, etc.

            Signs of the disease develop gradually. In the initial stages of tendonitis, pain appears exclusively against the background of heavy physical exertion and after long training. Unpleasant sensations are localized not only at the site of inflammation, but also in nearby tissues. The progression of the disease leads to the fact that pain appears after overwork, prolonged standing, and also intensifies due to the weather. Over time, they begin to bother the patient constantly, even at rest.

            In the knee area there are all the signs of an inflammatory process: pain, hyperemia, tissue swelling, local increase in body temperature and impaired functioning of the joint. When walking, a peculiar “creaking” sound may appear.

            If the patellar retinaculum is damaged, the pain increases sharply, especially as a result of climbing stairs or getting out of a chair. The progression of the disease leads to the fact that a person is forced to quit sports, because he is unable to even move normally. And any training contributes to a sharp deterioration in the patient’s condition.

            On palpation, severe tenderness of the medial tendon or lateral ligaments is noted, depending on where the inflammatory process is localized.

            Chronic tendinitis is sluggish, causing a gradual but progressive deterioration in the patient’s well-being.

            Drug therapy for the disease

            Treatment of knee tendonitis should be comprehensive. Self-medication is prohibited; you should immediately consult a doctor to prevent serious complications, in particular ligament rupture.

            First of all, the joint needs to be provided with complete rest so as not to further injure the tendon. The best option is to apply a plaster splint. You can also use improvised means to immobilize the limb.

            Drug treatment consists of the use of anti-inflammatory and analgesic drugs to relieve clinical symptoms and reduce the activity of inflammation. The following groups of drugs must be present in the therapeutic regimen:

          32. Nonsteroidal drugs (NSAIDs). Reduce the production of inflammatory mediators, help reduce pain and swelling. Restore range of motion in the affected joint. In the treatment of tendinitis, Diclofenac, Movalis, Ibuprofen and other agents are prescribed for local and systemic effects. You should definitely use ointment or cream on the area of ​​the sore knee. The simultaneous use of tablets or injection solutions will help enhance the effect of the drugs. NSAIDs should be used very carefully, since they can lead to complications in the mucous membrane of the stomach and duodenum, provoking the development of peptic ulcers. In no case should you exceed the recommended course or prescribed dosage.
          33. Hormonal drugs. Indicated for use in the absence of a positive result from NSAIDs. It is possible to administer glucocorticosteroids directly to the site of inflammation, which will enhance the therapeutic properties. Hormones should only be used under medical supervision as they can weaken the tendons, greatly increasing the risk of rupture.
          34. Broad-spectrum antibacterial drugs. Necessary for infectious nature of the disease.
          35. Platelet-rich plasma. Has the ability to stimulate regeneration processes in tendon tissue. The drug is injected into the pathological focus.

          After relieving acute inflammation, it is necessary to undergo a course of physiotherapy. Electrophoresis, iontophoresis, magnetic therapy, UHF and massage will speed up the restoration of damaged tissues and the patient’s recovery.

          The patient must undergo a course of physical therapy. The specialist will select the necessary exercises that will allow you to restore and strengthen damaged ligaments. In the future, the person must study at home independently.

          Surgery

          In the later stages of the disease, in case of a tear or complete rupture of the tendons, pes anserine tendonitis can only be treated surgically. At the same time, altered tissues are removed, cysts and other formations are removed.

          Depending on the severity of the pathological process, the operation is performed in 2 ways:

          1. Arthroscopic method. Indicated when a bone growth occurs in the kneecap, since the defect can be eliminated using special endoscopic equipment. Access to the pathological focus is carried out through several micro-incisions.
          2. Open method. Allows you to remove cysts and other growths in ligaments, and excises degenerative tissues. If necessary, the doctor scrapes the lower part of the kneecap to stimulate regeneration processes. To restore impaired functions of the quadriceps femoris muscle, reconstruction of the patellar ligament is performed. Open surgery is necessary for the development of stenosing tendinitis, accompanied by narrowing of blood vessels.
          3. The role of alternative medicine

            The use of traditional methods of therapy will help speed up the healing process. However, any method should first be agreed upon with the attending physician in order to prevent complications.

            Applying cold to the area of ​​the affected ligaments will help relieve pain and inflammation. To do this, you need to apply pieces of ice to your knee, first wrapping it in several layers of fabric so as not to cause frostbite to the skin. If this is not available, you can use frozen vegetables. Cold is indicated for use during the first 2–3 days after an exacerbation of the disease.

            Tea based on ginger and sarsaparilla roots has pronounced anti-inflammatory properties. You need to drink it 1-2 times a day for several weeks. Curcumin, which should be used as a seasoning for all dishes, will relieve pain and reduce inflammation. Good results are shown by using a decoction based on bird cherry berries (3 tablespoons of raw materials per 1 cup of boiling water). The anti-inflammatory effect of the drug is due to the tannins and anthocyanins it contains.

            Aloe compresses should be applied externally to the knee. To prepare the medicine, you need to cut off several leaves of the agave and place it in the refrigerator for a day so that the plant increases its healing properties. Before use, chop the raw materials, place the mass on the joint, cover the top with a cotton cloth, a plastic bag and insulate it with cotton wool or a scarf. The final step is to secure the bandage to the leg.

            A positive result from using a compress is only possible if it is applied correctly - each layer must overlap the previous one in order to achieve an increase in local temperature. This will activate blood circulation in the area where the application is applied and enhance the penetration of the healing components of the agave deep into the epidermis.

            As a base for a compress, you can use onion or bear bile crushed into pulp. It is advisable to make applications at night so that the healing agent affects the joint for several hours.

            An ointment made from arnica, wormwood or calendula will help reduce inflammation and swelling of the skin. The product should be rubbed into the knee 2-3 times a day.

            The use of ginger-based lotions shows good results. The root needs to be chopped, 2 tbsp. l. pour 500 ml of boiling water and leave for 30–40 minutes. As soon as the product has cooled slightly, soak a piece of cotton cloth or gauze in the solution and apply it to the sore joint for 10–15 minutes.

            Treatment of knee tendinitis should be carried out under medical supervision. Only a specialist can evaluate the effectiveness of therapy and, if necessary, adjust prescriptions.

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