In this article we will talk about such a common disease of the knee joint as tendonitis or tendinosis of the knee tendons. The term “tendonitis” comes from the Latin words tendo - tendon and itis - inflammation and in general it means inflammation of the tendons of the knee, as well as the tissues around them. This disease is especially well known to athletes, because it can be called their occupational disease.
There are many causes of tendinitis-tendinosis. But intense physical activity and constant microtraumatization of the tendons deserve special attention. During active muscular work, the greatest load falls on those places where the muscles are attached to the bones, which is where the tendons are located. During very active physical activity (particularly among professional athletes), tendons repeatedly succumb to microtrauma. If adequate rest is provided, damaged structures will heal and recover. If the processes of fatigue prevail over rest, then the damaged tissue does not have time to regenerate, microtraumas accumulate and lead to degeneration of the tendons of the knee joints and the development of fatigue injuries. The most common fatigue injury in sports is knee tendonitis. In medicine, there is even a term that refers to this disease as “jumper’s knee,” which clearly reflects the etiology of the lesion.
Other causes of knee tendinitis may include:
Jumper's knee is tendonitis of the patellar ligament, which runs from the kneecap down to the tibial tuberosity and is an extension of the quadriceps femoris ligament. This ligament helps to extend the leg, lifting it in a straightened state. When you move your leg, the attachment points of the patellar tendon bear a lot of stress. Mostly, inflammation and tendinosis develop on the pushing leg, but can occur on both limbs at the same time. Participants in sports that require a lot of jumping (basketball, boxing, steeplechase), as well as cyclists, suffer more often due to the enormous load on the knees.
The symptoms of tendinitis are very similar to the clinical picture of a sprain. Therefore, it is very important to correctly diagnose the pathological process of the knee joint in order to select the correct treatment.
Inflammation of the patellar ligament has several clinical stages:
Stage 1. Pain in the area of the lower part of the patella appears only during intense physical activity. Apart from this, no further discomfort is observed. If the athlete’s activity is at the normal level, then pain does not occur.
Stage 2. At this stage, pain occurs not only during active physical work. It can bother a person even at rest, but more often the feeling of pain or discomfort occurs after training. The nature of the pain is dull, sometimes paroxysmal. It is localized along the patellar ligament and on the sides of it.
Stage 3. This stage of the disease is characterized by the fact that the pain syndrome becomes very strong and pronounced. Over time, pain in the knee joint only increases if treatment is not prescribed. Discomfort and pain appear not only during or after physical activity, but also bother you at rest.
Stage 4. This is the last stage of the progression of the pathology and is more likely a complication of tendinosis. Prolonged inflammation of the ligament, if treatment is not prescribed on time and physical exercise continues, leads to rupture of the patellar ligament.
In addition to pain, inflammation of the patellar ligament may be accompanied by pain when palpating or pressing the area where the ligament attaches to the patella and the tibial tuberosity. If the inflammation has spread to its shell or adjacent tissues, then swelling and redness of the projection area of the patellar ligament is possible. Also characteristic is limited extension of the knee joint and the appearance of pain. Pain can also occur when pressing on the patella itself. Sometimes there is a crunching sound during active and passive movements in the knee.
To verify the diagnosis, in addition to the examination, the doctor may prescribe an X-ray examination, MRI, or ultrasound of the knee. All these examinations will help establish the correct diagnosis and carry out differential diagnosis in order to prescribe effective treatment.
If the disease has not yet gone too far, then treatment begins with conservative methods. As a rule, stages 1 and 2 of the disease respond well to non-radical methods of therapy. Drug therapy includes painkillers and anti-inflammatory drugs (ibuprofen, naproxen). They only relieve symptoms in the form of pain for a while, but do not provide recovery.
Treatment with physiotherapeutic (iontophoresis, magnetic therapy, UHF, electrophoresis) methods can have a positive effect on the dynamics of the disease. Exercise therapy also gives good results. There are special sets of exercises for stretching muscles and strengthening them.
Taping is a treatment method that is based on attaching special tapes (tapes) to the knee, which relieve the load on the patellar ligament. A similar method is to treat patellar tendonitis using a brace. The orthosis relieves the damaged ligament and alleviates the symptoms of the disease.
In all cases, fast and sudden movements with jumping should be avoided.
At stage 3, treatment begins with the same measures as in the early stages. If the ligament ruptures (stage 4), surgery is certainly needed. Arthroscopic (endoscopic surgery) or open (through a regular incision) removal of degenerative tissue in the area of the patella is performed. In addition to excision of the altered areas of the tendons, in some cases, during the operation, curettage of the lower part of the patella is performed in order to initiate the tissue restoration process. At stage 4, surgical reconstruction of the patellar ligament is performed, which allows the function of the quadriceps femoris muscle to be restored.
To avoid this disease, you must first warm up all muscle groups before playing sports. Also, you should not perform exercises on only one muscle group for a long time. When performing physical exercises, you should avoid sudden movements and lifting heavy objects with straight legs. All these actions lead to microtrauma of the patellar ligament and the development of tendinosis.
A fairly common disease characterized by damage to the tendon of the knee joint at the point of its connection with the bone, and subsequently the development of inflammation, is called knee tendonitis. Absolutely anyone can encounter this pathology, regardless of gender and age.
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In terms of incidence, tendinitis is equal to meniscal injuries. There are two menisci in the knee: lateral and medial. It is the medial meniscus that is more susceptible to injury, because it is less mobile and is more connected to the knee ligament. People who are actively involved in sports, teenagers and people over 40 years of age are more susceptible to developing tendinitis of the knee joint. Knee tendonitis can be acute or chronic.
Ignoring the symptoms of the disease is fraught with a decrease in the strength of the patellar ligaments, and subsequently their rupture. It is necessary to treat tendinitis on time, this is the only way you can avoid serious complications.
Otherwise, the disease is called “jumper’s knee.” This is due to the fact that most often it affects people involved in cycling, basketball, volleyball and other “jumping” sports. The disease is characterized by damage to the patellar ligament, which is attached to the tibia and is a continuation of the quadriceps femoris ligament. It is responsible for straightening the knee and lifting the limb in an extended form.
In most cases, the knee joint of the pushing leg is affected, but damage to both joints is also not uncommon. Due to large intense loads, a large number of microscopic damage occurs. With normal rest, restoration of damaged tissue is observed. If there is no rest as such, microtraumas lead to degenerative changes in the knee, in particular the tendon, which provokes the development of tendinitis.
The disease usually begins with inflammation of the tendon bursa or tendon sheath. It is often mistaken for a normal sprain of ligaments and tendons.
Only a qualified specialist can identify the pathology. Only he can prescribe the correct treatment. Therefore, the sooner you seek help from a doctor, the sooner recovery will occur and the lower the risk of complications.
There are many causes of knee tendinitis. Inflammation in the knee joint can be caused by:
Factors that provoke the development of inflammation include: long-term use of glucocorticoids, the presence of arthritis and diabetes mellitus, and renal failure.
Tendinitis can be infectious or non-infectious.
This video will tell you how to distinguish tendon problems from other pain in the knee joints:
Symptoms of tendonitis do not appear immediately. Moreover, after a knee joint injury (dislocation or subluxation), a person may not even be aware of a meniscus tear or the development of tendonitis. Symptoms of the pathology can be confused with tendobursitis of the pes anserine tendons, characterized by intense pain.
Anserine bursitis can develop as a result of trauma (subluxation, joint dislocation, meniscus tear, blows). The bursa anserine is located between the medial collateral ligament and the tendons of the pes anserine. The diseases are similar, but require different treatments. Therefore, you should not self-medicate and guess that it is a tear or damage to the meniscus, subluxation. If you experience pain in your knee joint, seek medical help. Only he, based on complaints, examination and a number of additional studies, will be able to identify the pathology.
Knee inflammation is accompanied by:
Increased pain is observed when climbing stairs or abruptly getting up from a sofa or chair.
There are four stages of tendon inflammation. The first is characterized by the appearance of symptoms exclusively after intense physical activity. The second is accompanied by the occurrence of periodic dull pain, for example, after light load on the joint or exercise. As for the third stage, it is characterized by the appearance of pronounced pain, which can occur even at rest.
The last degree of damage and inflammation of the tendon is the development of a pathological process. This stage, if untreated, is fraught with rupture of the patellar ligaments.
Diagnosis of pathology can only be carried out by a specialist. In order to identify the disease, the following is prescribed:
Timely and correct diagnosis of pathology helps to identify the degree of development of tendinitis, as well as determine the specific damaged tendon. Remember, the sooner you contact a specialist, the sooner treatment will begin and the better the prognosis will be.
Knee tendonitis is treated with several methods. The main directions of treatment of the inflammatory process in the knee joint include:
Often, as an auxiliary method to facilitate the functioning of the patella, the use of self-adhesive tapes (tapes) and knee orthoses and bandages is prescribed. Knee taping helps in fixing the muscles in damaged areas. An orthosis is one of the most effective devices that helps both treat a damaged joint and prevent damage during training or various daily activities.
The video below explains how to attach the tape to your knee yourself:
Even “advanced” joint problems can be cured at home! Just remember to apply this once a day.
Treatment with medications
To treat the pathology, the use of anti-inflammatory and analgesic drugs from the NSAID group is prescribed: Ibuprofen, Naproxen, Diclofenac. These remedies help minimize pain and eliminate inflammation. The above medications are prescribed both internally and externally, in the form of ointments, creams and gels.
However, doctors do not advise taking such drugs for a long period, because this can lead to disastrous consequences from the gastrointestinal tract. NSAIDs are prescribed in two-week courses.
In cases of severe inflammation, antibiotics are prescribed. Corticosteroid injections help minimize pain. Remember, only a doctor can prescribe this or that drug. Overuse of corticosteroids can weaken the tendons and lead to their further rupture.
As for physiotherapy, for tendinitis the following are prescribed: UHF, magnetic therapy, electrophoresis and iontophoresis.
In addition, massage and exercises aimed at stretching the muscles and strengthening them, and helping to restore the tendons after treatment, help in the treatment of knee tendonitis.
The operation is usually performed at the last stage of tendinitis. Surgery is aimed at removing the affected tissue in the area of the patella. As a rule, arthroscopy or open surgery is prescribed.
If there are calcium growths on the patella (calcific tendinitis), leading to pinched ligaments, arthroscopy is prescribed. The growths are removed through small incisions.
If cysts or any other volumetric changes appear, open surgery is prescribed. Quite often, in addition to excision, during surgery, curettage is performed in the lower part of the patella. This helps activate the recovery process.
At the last stage, in order to restore the functions of the quadriceps femoris muscle, the ligaments are reconstructed.
During surgery, the Hoffa fat pad is often completely or partially removed and the ligament attachment site is relocated if the axis is disrupted.
If purulent tendovaginitis is associated with tendinitis of the knee joint, the purulent contents are urgently pumped out from the tendon sheath. The duration of the postoperative period is three months.
The use of alternative medicine
Remember, treatment for tendinitis should be prescribed exclusively by your doctor. Unofficial medicine is effective and efficient, but do not forget that they are a complement to traditional medicine and that is why you should not replace medications with infusions and compresses.
To treat tendonitis, it is recommended to use products both for external use and for oral administration. Traditional medicines help minimize inflammation, improve the condition, and strengthen the immune system. If they are used appropriately, recovery will occur many times faster.
Oral preparations
Products for external use
The use of physical therapy
There is a developed course of exercise therapy recommended during the recovery period. Gymnastics should be done every day. Duration of the course is until pain and discomfort completely disappear.
Walking, extension and leg swings with resistance are also used.
In order to prevent the development of such a common pathology as tendinitis of the knee joint, adhere to the following recommendations:
Following these simple recommendations will help prevent the development of tendinitis. If symptoms of pathology appear, do not hesitate to visit a specialist. The disease must be treated in a timely manner and only under the supervision of a specialist.
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Knees, which are often susceptible to injuries - bruises, fractures, dislocations, torn ligaments - are not immune to various diseases. Diseases can be of a different nature, affecting all structures of the knee joint, including ligaments and tendons, the inflammation of which is commonly called tendonitis. The specificity of the symptoms of tendinitis of the knee joint requires differentiated diagnosis for successful treatment of the disease and complete restoration of the functions of the limb.
The knee joint has a special anatomical structure that allows it to enhance the action of the quadriceps femoris. This muscle group, which occupies the entire anterior and partially lateral surface of the thigh, is responsible for the extension of the lower leg.
The quadriceps muscle consists of four separate muscles of the femoral group, each of which has its origin at the top of the thigh. Descending to the knee joint, they pass into one common tendon, which covers the patella and below the kneecap is attached to the tuberosity of the tibia of the leg. This part of the knee tendon is called the patellar ligament.
An inflammatory disease that affects the knee tendons and surrounding tissues is called knee tendinitis . Knee tendinitis is fairly common regardless of age or gender.
The causes that provoke the occurrence of inflammatory processes in the tendons (tendinitis) may be:
The risk group for knee tendinitis consists of people who move actively and a lot (athletes), as well as those whose bodies undergo significant age-related changes at a certain period of life (teenagers, older people).
In addition, patients with autoimmune diseases affecting the joints (rheumatoid arthritis, systemic lupus erythematosus), diabetes or chronic renal failure are at risk.
Based on the causes of occurrence, tendinitis of the knee joint is divided into:
Occurs due to constant stress and periodic injuries to the knees (for example, in athletes).
Associated with degenerative-dystrophic changes due to:
Tendinitis of the knee joints is also distinguished:
According to the nature of the course of the disease, acute and chronic tendinitis are divided.
The following symptoms indicate the development of knee tendinitis:
The inflammatory process in the tendons of the knee joint occurs in stages:
The knee of the affected limb differs from the healthy one in increased size, swelling, redness, and increased temperature. When palpated, pain is expressed.
Indicators usually change only with advanced disease or in the case of combined pathologies. If it is just tendonitis due to injury, then a general blood test is not prescribed.
With advanced tendinitis, the following abnormalities in the blood composition may be observed:
The choice of treatment depends on the cause of the tendonitis in a given case. However, there is a universal list of actions used for tendinitis of almost any etiology (but with some exceptions):
The following types of physical therapy are used to treat knee tendinitis:
If a tear/rupture of the ligaments and tendons of the knee joint occurs, surgical treatment is required. It involves excision of the affected tissue and repair of the damaged tendon/ligament.
Some surgical interventions can be performed openly, while others can be performed endoscopically using an arthroscope.
Restoring knee function after such operations takes approximately 2–3 months.
The most common home remedy is to apply ice to the affected knee. In addition, a variety of compresses, ointments, and applications are used.
Ginger promotes tissue regeneration and relieves inflammation. In one tablespoon of grated ginger, add 4 drops of peach or apricot oil, dilute with 1 tablespoon of water. Apply the resulting mass onto a gauze pad, cover with polyethylene and apply to the sore spot for one hour.
Grind dry arnica flowers and add pork fat. Over low heat, without bringing to a boil, let the mixture sit for 10-15 minutes. Apply the resulting remedy for tendinitis in the form of an ointment 2 times a day.
Before cooking, the cut leaves of the plant must be kept in the refrigerator for at least a day. After this, chop the aloe and squeeze out the juice. Use fresh juice for compresses, which for tendonitis are applied to the knee joint 4 to 6 times a day.
Basically, such methods are effective for minor traumatic injuries of the knees that cause inflammation of the tendons. They can reduce the severity of tendonitis symptoms, relieve swelling and relieve pain.
Since the main risk factor for tendonitis is sports injuries, it is necessary to warm up before physical activity.
Increasing the load during exercise should be done gradually, avoiding overstrain of the ligaments and tendons. If you feel severe pain when performing any exercises, you need to stop moving or ease the load. Under no circumstances should you endure pain!
You cannot perform exercises on the same joints for a long time, this can lead to injury.
Large human muscle formations are attached to bones using tendons. This section of the muscle bears a large load, often runs in narrow channels and therefore has a tendency to become inflamed.
A tendon disease caused by an inflammatory process with the development of subsequent fiber degeneration is called tendinitis. If the disease is localized at the site of attachment of the element to the bone, the term enthesopathy is used.
The inflammatory process can develop in the tendon under the influence of various factors. The disease most often results from:
These factors are often combined with each other, collectively leading to the development of tendon disease.
The clinical picture of the disease varies significantly depending on the location of the affected tendon. However, there are common symptoms of tendonitis that indicate inflammation of the ligaments. These include:
The formation of dense subcutaneous nodules is a sign of a late stage of the disease called calcific tendinitis.
These signs most likely occur with tendinitis of any location; other symptoms are more specific and will indicate the pathology of a particular tendon.
The movements of the lower jaw are ensured by the work of the masticatory muscle, which is responsible for the mobility of the temporomandibular joint. If the tendon of this muscle becomes inflamed, the disease occurs, temporal tendonitis.
Provoking factors are often injuries, rheumatic diseases - systemic lupus erythematosus, malocclusion, infection of the dental area, osteomyelitis of the lower jaw.
Symptoms of the disease are difficulty speaking, chewing, swelling in the cheek and temple area, subcutaneous tissue compaction and pain that can mimic a toothache. Temporal tendonitis differs from dental pathology by increased symptoms when the lower jaw moves.
Inflammation of the tissues of the pleural girdle is a common phenomenon that occurs during intense stress, infections, arthritis, gout, cervical osteochondrosis and other pathological conditions. Shoulder tendonitis manifests itself as inflammation of the supraspinatus and biceps tendons (biceps tendinitis):
The wrist flexor tendons pass through the wrist in a narrow channel, in close contact with each other. This factor causes severe inflammatory lesions in the tissues of the hand, affecting several formations at once.
If the disease develops in the upper part of the hand - at the styloid process of the radius, then the pathology is called styloiditis. Frequent monotonous movements and microtrauma contribute to the development of the disease.
Pathology occurs in pianists and people who work at a computer. If an uncomfortable position is created for the hand during work, pinching of the flexor tendons occurs and an inflammatory process develops. Diagnosis is based on the use of clinical and instrumental methods:
Most often, anti-inflammatory drugs and massage of the affected arm are used to eliminate the pathology. Immobilization of the hand in special bandage devices also has a positive effect.
If the inflammatory process develops at the junction of the gluteal muscle into the tendon attached to the thigh, a characteristic clinical picture occurs. The patient feels muscle weakness, difficulty changing body position, and walking for long periods of time.
The disease does not manifest itself visually or palpably, however, in a chronic course, tendinitis of the gluteal muscles can lead to serious consequences, such as muscle fiber atrophy.
In this case, the fibers are replaced by connective tissue, which cannot perform the functions of movement and support. There is a constant feeling of weakness in the lower limb, the inability to exercise. A severe consequence of atrophy is rupture of the gluteal muscle, which may require surgical correction.
The large tendon of the quadriceps femoris muscle passes into the patellar ligament. This element of the musculoskeletal system bears significant loads when the knee moves. When the patellar ligament becomes inflamed, it causes tendinitis of the knee joint.
The occurrence of the pathology is associated with intense tension in the quadriceps femoris muscle, injuries to the patella, and playing sports on a hard floor. Another factor in the disease is old age. Over the years, degenerative changes appear in the patellar ligament, leading to pathological inflammation.
The disease manifests itself as pain and discomfort in the quadriceps femoris and patella area, which intensifies after exercise. In the chronic stage, inflammation of the knee ligaments causes symptoms at rest and can lead to rupture of the patellar tendon.
Diagnosis of inflammation of the quadriceps tendon is based on a series of instrumental studies. These include:
In the area of the ankle, the joint that supports the entire body when walking, inflammation of the tendons of the lower leg muscles can also occur. The most commonly affected tendons are:
Diagnosis of pathology includes X-ray and MRI of the ankle, heel, and small joints of the foot.
During the chronic course of the inflammatory process, calcium salts accumulate in the tissue, which aggravate the symptoms of the disease and cause calcific tendinitis. This form of pathology may manifest as less severe pain than active inflammation, but motor function is more clearly affected. It is possible to develop persistent joint contracture, which leads to disability of the patient.
Calcific tendinitis is detected by X-ray or MRI of the affected tissue. Often the form of the disease requires surgical treatment.
How to treat tendonitis? Even experienced traumatologists often cannot answer the question. The disease requires an integrated approach, eliminating the cause of inflammation, as well as relieving the symptoms of the disease.
Treatment methods include:
The choice of a set of measures is up to the attending physician; changing the method of treatment, frequency and dosage of drugs is not recommended.
Includes the use of drugs that relieve symptoms of the disease. These means include:
In case of bacterial enthesopathy, it is mandatory to prescribe antibiotics that eliminate the cause of the disease - the influence of pyogenic microorganisms.
UHF, magnetic therapy, electrophoresis, ultrasound give good treatment results in combination with manual therapy of the affected tendon. Acupuncture of the quadriceps femoris muscle allows you to maintain the functional activity of this area of the leg.
The procedures are aimed at improving blood circulation in the pathological focus, relieving muscle spasms, and reducing tissue swelling.
Whether it is the ligaments of the hand, the patellar ligament or the quadriceps tendon, massage helps reduce the symptoms of the disease and relieve inflammatory syndrome.
Exercises aimed at developing the tendon are recommended after the acute inflammatory syndrome has been relieved, during which immobilization (immobilization) of the joint area with a fixing bandage or a bandage is prescribed.
Exercise therapy allows you to reduce the intensity of pain, increase the mobility of the tendon, and prevents the development of the calcifying form of the disease. Tendonitis of the shoulder joint, inflammation of the ligaments of the hand, and heel joint cannot be eliminated without adequate gymnastic training. Without intense exercise of the quadriceps femoris muscle, it is almost impossible to achieve recovery of the patellar tendon.
Exercises can be performed at home after consulting a doctor.
This method should always be agreed with the attending physician and used only in the absence of contraindications. In the treatment of ligament inflammation, folk remedies are used:
Surgical intervention is performed in case of ineffectiveness of conservative treatment methods. It includes revision and drainage of the affected space, resection (removal of part) of dead fibers, decompression of ligaments in narrow canals. Also, the method of surgical treatment is used in the case of a chronic form of the disease.
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The term “tendinitis” (other names are 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 kneecap and nearby tissues.
Inflammation occurs at the point of contact between 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:
Figure: Knee injuries in gymnasts
The sports that most often lead to ligament disease include cycling, basketball, volleyball and other “jumping” sports, which is why one type of tendinitis is called “jumper’s knee.”
This disease affects the patellar ligament, which runs down from the kneecap, attaches to the tibia and is an extension of the quadriceps femoris ligament. This ligament helps to extend the knee and lift the leg in an extended manner.
Most often the disease affects the knee of the pushing leg, but it can also affect both.
Great physical activity causes microscopic damage. With sufficient rest, they heal and the tissues are restored.
Otherwise, microtraumas, accumulating, lead to tendon degeneration and the development of fatigue injuries, which include tendonitis of the knee joint.
Tendinitis can also affect people who spend long periods of time in awkward positions.
The disease can begin with:
Knee tendonitis is sometimes confused with a sprained knee tendon or ligament.
The following types of tendinitis are distinguished:
As a result of the disease, the mechanical strength of the patellar ligament decreases, which may result in its partial or complete rupture.
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Knee tendinitis occurs for many reasons, including:
Depending on the cause of the disease (the absence or presence of an infectious component), there are two types of tendinitis:
Determining the cause of the disease is a decisive factor in prescribing treatment, which will lead to a complete cure as quickly as possible.
Provoking factors can be long-term use of glucocorticoids and systemic diseases: rheumatoid arthritis, chronic renal failure, systemic lupus erythematosus, diabetes mellitus.
Typical manifestations of tendinitis that indicate the presence of the disease include:
Sudden sharp pain may occur when walking up stairs or getting out of a chair.
It prevents you from working and leading a normal lifestyle, and even more so from playing sports.
Typical symptoms are easily detected by careful examination of the knee and palpation of the place where the ligaments attach to the kneecap.
When the process is deeply localized, pain occurs when the ligament is deeply pressed.
There are 4 stages in the development of the disease:
To prescribe adequate treatment, it is necessary to verify the diagnosis not only by the cause of the disease, but also by the stage of development.
To clarify the diagnosis, your doctor may prescribe diagnostic tests:
Correct diagnosis makes it possible 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 refined diagnosis sounds more detailed, for example, “tendinitis of the internal collateral ligament of the knee joint, stage 3,” which is made when the internal collateral ligaments of the knee joints become inflamed.
This differentiation makes it possible to determine the need for mobilization, its duration and methods of treatment.
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Knee tendonitis is treated in modern conditions:
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 completely immobilize it.
To reduce the load on the knee, crutches or a stick are used, and to immobilize the knee, the knee is cast or a splint is put on it.
A combination of physiotherapeutic procedures and medications is used.
Photo: splint for immobilizing the knee joint
In case of unfavorable development of the disease, surgical intervention is prescribed.
To unload the patellar ligament use:
Orthoses are an effective treatment for knee joint diseases and are suitable for preventing tendon damage during exercise, fitness and gardening.
Photo: knee orthosis
For chronic forms of the disease, massage is recommended.
Anti-inflammatory and painkillers from the group of non-steroidal drugs (for example, naproxen and ibuprofen) are prescribed.
Medicines relieve pain and inflammation, but do not lead to complete recovery. They can be prescribed internally, in the form of injections (to achieve a quick effect) and externally in the form of gels, ointments and creams.
Long-term use of nonsteroidal drugs can adversely affect the gastric mucosa, so their use is limited to two weeks.
If the effectiveness of these drugs is low, injections of corticosteroids and platelet-rich plasma are injected into the lesion to relieve pain and inflammation.
In case of severe inflammatory process in cases of infectious origin of tendinitis, antibiotics and other antibacterial drugs can be prescribed.
Corticosteroid injections can help relieve pain, but they can be dangerous to overuse because they can weaken the tendons, causing them to rupture.
Platelet-rich plasma injections are a new treatment that promotes tendon tissue regeneration.
Of the physiotherapeutic methods of treatment that give a positive effect in the treatment of tendinitis, the following are used:
Special sets of exercise therapy exercises help to stretch the muscles and strengthen them, which also contribute to the restoration of the tendon after treatment.
At stage 4 of the disease, if the tendon is torn or completely ruptured, surgery is necessary.
Surgical intervention to remove degenerative tissue in the area of the patella is carried out in two types:
If there is a bone growth on the patella that leads to pinching of the ligament, it can be removed arthroscopically, that is, through tiny incisions.
If cysts or other voluminous changes appear in the ligament, they can only be corrected with open surgery.
Sometimes in addition to excision of degenerative areas of the tendon. During the operation, curettage is performed in the lower part of the patella, as a result of which the recovery process is activated.
At the last stage, the patellar ligament is reconstructed to restore the function of the quadriceps femoris muscle.
Many doctors consider it necessary to shorten the lower pole of the patella when operating on tendinitis of the knee joint, as they believe that this causes the ligament to be pinched.
During the operation, the Hoffa fat pad may be partially or completely removed and the ligament attachment site may be relocated if the axis is disrupted.
Surgery is also performed for stenosing tendonitis (a disease with narrowing of blood vessels).
If the disease is accompanied by purulent tenosynovitis, then an urgent autopsy is performed and pus is pumped out from the tendon sheath.
The postoperative period ranges from two to three months.
Treatment of tendonitis with home folk remedies involves relieving pain and inflammation using both internal and external influences.
Oral administration allows medicinal drugs to enter the bloodstream through the gastrointestinal tract, and local administration allows active substances to penetrate directly through the skin.
For oral administration it is recommended:
At home, for local external use it is recommended:
If the joint is not hot to the touch, you can begin compresses and contrast procedures.
They consist of alternating massage with ice and heating with millet cereal, heated in a frying pan and placed in a cotton bag or sock.
This procedure improves blood circulation and promotes tissue restoration.
In the initial stages and chronic forms, treatment of tendinitis with folk remedies can bring significant relief, but before starting it, you should consult a doctor.
An important role in the prevention and treatment of diseases of the 1st and 2nd stages is given to physical therapy.
The exercises are designed to stretch and strengthen the quadriceps muscle.
Exercise therapy classes can take up to several months until complete recovery and the ability to begin training or regular physical activity.
Fig.: quadriceps femoris muscle
Yoga classes have a good effect.
The physical therapy complex includes exercises:
Professional athletes are recommended to add squats on a squat (inclined plane) with and without weights after the pain disappears.
After treatment, rehabilitation is of great importance, especially for athletes, to return to sports or normal significant physical activity and to prevent relapses.
Exercises are performed gradually, in several stages, with increasing load.
After eccentric stretching of the quadriceps muscle, ice is applied.
A return to the previous volume of loads is allowed if there is no pain or discomfort during exercise and the volume of contraction of the quadriceps muscle is restored to 90%.
To avoid illness, it is enough to follow the following precautions:
Like any other disease, tendonitis is easier to prevent than to treat it later.
In modern medicine, there are many possibilities for treating tendinitis of the knee joint, which lead to a complete cure if all medical recommendations are followed.
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