Knee tendinitis [symptoms and treatment]

Tendinitis of the calcaneal tendon in ICD 10 has the code M76.6 This is a disease in which the inflammatory-degenerative process is localized to the Achilles tendon. Athletes are mainly susceptible to the disease, since long-term sports are accompanied by excessive stress on the Achilles tendon, which results in injuries. The disease is often diagnosed in older people. Patients who are treated for Achilles tendonitis at Yusupov Hospital have the following benefits;

European level of comfort;
Diagnostics using the latest devices from leading global manufacturers;
Treatment with effective medications that are registered in the Russian Federation and have minimal side effects;
Restoring the function of the lower limb using innovative rehabilitation techniques;
Individual approach to the treatment of each patient.

Depending on the course of the disease and clinical picture, there are 3 main types of heel tendonitis:

Peritendinitis is a type of disease that is characterized by inflammation and degenerative process of the soft tissues surrounding the joint;
Tendinitis is an inflammatory lesion of the Achilles tendon itself, without involving adjacent tissues in the pathological process;
Enthesopathy is a degenerative process in the Achilles tendon at the junction with the bone (sometimes accompanied by the development of a heel spur).

Severe cases of calcaneal tendonitis are discussed by professors, associate professors, and doctors of the highest category at a meeting of the Expert Council. Leading specialists in the field of rheumatology and orthopedics collectively decide on the need to perform surgical intervention in patients for whom all innovative methods of conservative therapy have proven ineffective. The operations are performed by traumatologists who are fluent in the techniques of modern surgical interventions on the Achilles tendon.

What is knee tendonitis?

Knee tendonitis occurs quite often among the population, regardless of gender and age category. It is accompanied by a pathological process localized in the area of contact between the tendon and the bone. This disease is often equated to meniscus lesions - in terms of frequency of occurrence.

Most often, tendinitis of the knee joint occurs in adolescents and middle-aged people, as well as people involved in active sports activities. The disease can be acute or chronic. If treatment for the above-described ailment is not started in a timely manner, this can provoke weakening of the ligaments in this area, even to the point of their rupture.

However, restoration of damaged tissue is possible with regular and proper rest. In its absence, microdamage can provoke serious degenerative disorders, namely, tendinitis of the knee joint.

To make an accurate diagnosis and draw up a competent treatment plan, it is necessary to deal with experienced and qualified specialists. The sooner you go to the clinic, the better your chances of recovering your knee joint.

What causes knee tendinitis to develop?

The main reason that can provoke tendonitis of the knee joint is the increased intense load on this area of the leg. Microtraumas resulting from it can lead to a severe inflammatory process.

Also, the following factors can cause the development of the disease:

Excessive stress on the joints that occurs when jumping, during sports jogging and when climbing stairs;
Knee injury, flat feet;
Insufficient flexibility of the thigh muscles, their weakness;
A sharp increase in the intensity of physical activity;
Rapid weight gain, obesity.

The increased risk of patellar tendonitis in women is due to having wider hips than men.

If you ignore knee tendonitis and its symptoms for a long time, and do not give up your usual lifestyle, regular microtraumas can cause significant impairment of tendon function, and also lead to their complete destruction. In the event of serious complications, which include tendinosis, pain can continue for several years and provoke rupture of the damaged tendon.

Causes of Achilles tendinitis

The main cause of tendinitis is damage to the Achilles tendon due to overuse. The heel tendon plays an important role in walking and moving the lower limbs, because it has natural elasticity and great endurance. With age, the stretchability and endurance of the tendon deteriorate. A slight load leads to microtrauma and rupture of tendon fibers.

The second reason for the development of Achilles tendonitis is a sudden attempt to run in people over forty years of age. The tendon, not accustomed to heavy loads, cannot withstand it, and its fibers begin to tear. Flat feet with the foot falling inward can lead to the development of the disease. With excessive pronation, pathological excessive stretching of the Achilles tendon occurs, which over time leads to disruption of the integrity of its fibers.

The following additional unfavorable factors increase the likelihood of developing tendinitis:

Playing sports without pre-warming the muscles;
Wearing high-heeled shoes;
Wearing uncomfortable shoes for a long time;
Haglund's deformity (bone growth at the tendon insertion site).

Rheumatologists at the Yusupov Hospital determine the cause of Achilles tendonitis in each case and direct all efforts to eradicate it.

Symptoms of knee tendinitis

Pathological processes in the tendons located in the area of the knee joint are most often accompanied by the following symptoms:

Pain in the area above the tendon. Increases with jumping and jogging;
Feeling of stiffness in the knee joint in the morning. Caused by a decrease in elasticity at the site of the lesion;
Thickening of the damaged ligament;
In the acute form of the disease, severe swelling occurs in the area of the soft tissues located around the tendon. The temperature of the skin above it may also increase and beauty may appear;
A cracking sensation in the knee joint when squatting or walking.

Pain increases gradually as physical activity increases. The most sensitive area is the area above the damaged ligament.

Make an appointment Online booking

Clinic on Krasnopresnenskaya +7 (499) 252-41-35 Volkov lane, 21
Clinic on Varshavskaya +7 (499) 610-02-09 Varshavskoe highway, 75, building 1
Clinic in Annino +7 (495) 388-08-08 Varshavskoe highway, 154, building 1

Symptoms

Pain manifests itself with active movements. Projected over the area of the affected tendon. There is no pain with passive movements. In addition, there is pain on palpation of the affected tendon, changes in the skin in the area of the affected tendon: possible redness, a local increase in temperature, local edema, swelling in the area of the affected tendon, the intensity of the pain syndrome increases over time. At first, a person is bothered by minor pain in the area of the affected tendon, which does not interfere with his daily life. But gradually the pain syndrome intensifies, the pain becomes excruciating, strong, unbearable, disrupting the normal rhythm of life.

Stages of development of knee tendinitis

The lack of ability of the tendon to absorb increased loads provokes its damage. The disease is characterized by 4 stages, depending on the severity:

Reactive tendonitis. Tissues have a normal ability to adapt to injury. Pain syndrome occurs exclusively after exercise, while the functions of the knee joint are not impaired.
Tendon dysfunction. In this case, degenerative processes prevail over restorative ones. Discomfort is present both during the period of exercise and after it. The patient is able to lead an active lifestyle. If further damage to the ligament is prevented, experts give good prognoses.
Degenerative tendinitis. It is characterized by the presence of pain during and after exercise, and the death of damaged cells. The amount of movement in the joint decreases. Without treatment, it becomes impossible to restore the function of the affected knee and return to sports activities.
Tendon rupture. Acute pain appears in the area of the joint. It is characterized by complete loss of function of the knee joint and loss of its motor activity. If acute knee tendinitis occurs, treatment can bring the desired result only after surgery.

Symptoms and diagnosis of Achilles tendinitis

The clinical picture of acute heel tendonitis begins with a gradual increase in pain during exercise. When palpating the Achilles tendon, pain and discomfort intensify. When the patient is at rest, the pain goes away, but with repeated exercise it occurs again. A swelling forms along the tendon, closer to the heel.

When Achilles tendinitis becomes chronic, the pain does not go away even after prolonged rest. The patient has difficulty lifting on his toes, jumping, or walking up stairs. Sometimes he can't stand on his toes. In rare cases, when trying to rise on your toes, a characteristic creak occurs.

The diagnosis of “Achilles tendinitis” is made by rheumatologists and orthopedists based on the patient’s complaints, history of the disease, and examination results. In some cases, doctors use additional diagnostic methods:

X-ray of the ankle joint;
Ultrasonography;
Magnetic resonance imaging.

Using an x-ray, I identify areas of tendon calcification and bone tissue pathology. Ultrasound and magnetic resonance imaging are more accurate diagnostic methods. Using these techniques, the localization and size of areas of inflammation and degenerative changes in the Achilles tendon are accurately determined.

Diagnosis of knee tendinitis

In order to accurately diagnose the disease, you should contact competent specialists. In this case, the mandatory procedures are:

Carrying out research in laboratory conditions. They allow you to track violations if the cause of the disease is any infectious process or rheumatoid damage to the cartilage tissue of the joint;
X-ray. It is considered an effective way to identify the disease only when it is acute in nature, associated with the accumulation of uric acid salts or the appearance of bursitis;
Ultrasound. Makes it possible to diagnose a disorder in the tendon structure;
MRI, CT. Allows you to detect damage in the area of ligaments.

Only if the disease is detected in a timely manner can its stage be accurately determined and the correct treatment prescribed.

Treatment of knee tendinitis

If a patient is diagnosed with knee tendinitis, treatment involves the use of several techniques. Their choice depends on the degree of the degenerative process. The most popular of them are:

Use of medications;
Performing physiotherapeutic procedures;
Surgical procedures;
Alternative treatment for knee tendinitis;
Exercise therapy.

Often, as an additional method to facilitate the functioning of the joint and fix the muscles, special knee orthoses and self-adhesive tapes are used.

Treatment of tendonitis with shock wave therapy

The most effective method of eliminating inflammatory processes in the tendon area is shock wave therapy. Using this technique, it is possible to quickly deal with calcium deposits and eliminate the need for surgical intervention.

SWT for tendonitis is an innovative method that allows you to obtain the following positive effects:

Relieve and then completely eliminate pain;
Destroy calcium deposits;
Restore metabolic processes;
Normalize blood circulation in the affected area;
Eliminate inflammation;
Restore motor activity.

You can achieve positive dynamics and get lasting results after the first sessions of the procedure. Their frequency and intensity are selected individually. At the same time, timely contact with a specialist is of particular importance, which makes it possible to achieve a lasting healing effect in more than 90% of cases.

Our staff consists of specialists of the highest category who are fluent in working with innovative Swiss equipment, which is the key to effective treatment of knee tendinitis through shock wave therapy.

Read more about treatment of tedinitis with UVT »

Use of medications (ointments)

If you have been diagnosed with tendinitis of the knee joint, treatment of the disease can begin with taking medications that are aimed at relieving pain and eliminating inflammation. These include Diclofenac and Ibuprofen. These drugs relieve pain and eliminate the source of inflammation. If you have tendinitis of the knee joint, the above remedies can be used not only orally, but also in the form of an ointment .

When diagnosing an acute inflammatory process, it is advisable to use antibacterial therapy. Corticosteroid injections are also recommended to reduce pain.

Make an appointment Online booking

Clinic on Krasnopresnenskaya +7 (499) 252-41-35 Volkov lane, 21
Clinic on Varshavskaya +7 (499) 610-02-09 Varshavskoe highway, 75, building 1
Clinic in Annino +7 (495) 388-08-08 Varshavskoe highway, 154, building 1

Surgery

If a patient has been diagnosed with knee tendinitis in an advanced stage, treatment is performed exclusively through surgical procedures. During them, damaged tissue in this area is removed.

When diagnosing calcium deposits in the affected area, arthroscopy is performed. During this procedure, the surgeon makes small incisions through which the growths are removed.

In the case of cyst-like formations, open surgery is performed. Curettage is also practiced in the area under the knee joint, which allows you to start the process of tissue regeneration.

Also, tendinitis of the knee joint involves treatment by reconstruction. This promotes rapid restoration of tendon function. In this case, at the time of the intervention, partial and complete removal of loose tissue located under the kneecap is carried out and it is transplanted into the area where the tendon attaches.

Alternative treatment for knee tendinitis

Regardless of the stage at which you are diagnosed with knee tendonitis, only a competent specialist should evaluate the symptoms and prescribe treatment. Even taking into account the effectiveness of folk remedies, their help should be resorted to only in combination with medications.

For tendinitis of the knee joint, you can treat with ointments, as well as use herbal remedies intended for oral administration. They help relieve pain, improve the functioning of the immune system and help normalize the general condition. If they are used correctly, relief comes much faster.

Oral products:

Ginger. Infuse crushed rhizomes in a thermos and 300 ml of boiling water. Take 1/3 of the contents 3 times a day;
Curcumin. Allows you to relieve pain. Used as a seasoning;
Walnut. 1 glass of partitions is poured with 0.5 liters of vodka. The infusion period for the composition is 21 days. To achieve maximum effect, take 20 drops 2 times a day;
Bird cherry. 20 g of fresh berries are poured into 1 glass of boiling water. Take 50 ml 3 times a day.

External means:

Use of ice. Experts advise doing a daily massage of the affected area with an ice cube. The duration of the session is 15 minutes;
Aloe. Take the leaves of the plant and place it in a cool place for 24 hours. Next, the raw materials are crushed and squeezed. A gauze pad soaked in aloe juice is applied to the affected area for 3 hours. Compresses should be changed several times a day;
Arnica. An ointment made from crushed berries and melted fat is effective. Rub the resulting product onto the sore spot 2 times a day. It allows you to quickly eliminate swelling and inflammation.

Exercise therapy for knee tendonitis (exercises)

There are specially designed exercises that demonstrate increased effectiveness for knee tendinitis. They are recommended to be performed during the recovery period after an illness. Gymnastic exercises are carried out daily until the pain syndrome is completely eliminated. Below we will talk about them in more detail:

While in a side-lying position, lift both legs. To achieve the desired result, you should do at least 5 repetitions. With each session you can increase the number of exercises;
Lie down on your back. Raise your leg up at a 90 degree angle. To get maximum effect you should do about 5 repetitions. Similar movements must be made with the second leg;
Lean against the wall. Press the ball with your knees. Do the exercise many times.
While sitting on a chair, raise and lower your legs.
Take regular walks.

Make an appointment Online booking

Clinic on Krasnopresnenskaya +7 (499) 252-41-35 Volkov lane, 21
Clinic on Varshavskaya +7 (499) 610-02-09 Varshavskoe highway, 75, building 1
Clinic in Annino +7 (495) 388-08-08 Varshavskoe highway, 154, building 1

Tendinitis

Tendonitis usually develops gradually. At first, the patient is bothered by short-term pain that occurs only at the peak of physical activity in the corresponding area. The rest of the time there are no unpleasant sensations, the patient maintains his usual level of physical activity. Then the pain syndrome becomes more pronounced and appears even with relatively light loads.

Subsequently, pain due to tendonitis becomes intense and paroxysmal and begins to interfere with normal daily activities. On examination, redness and a local increase in temperature are detected. Sometimes swelling appears, usually mild. Pain is detected during active movements, passive movements are painless. Palpation along the tendon is painful.

A characteristic sign of tendinitis is a crunching or crackling sound when moving. The sound can be loud, easily audible at a distance, or detectable only with the help of a phonendoscope.

Lateral tendonitis

Lateral epicondylitis (lateral tendinitis or tennis elbow) is an inflammation of the tendons that attach to the extensor muscles of the wrist: the extensor carpi brevis, the extensor carpi longus, and the brachioradialis muscle. Less commonly, the tendons of other muscles are affected: the extensor carpi ulnaris, the extensor radialis longus and the general extensor digitorum.

Lateral tendonitis is one of the most common diseases of the elbow joint in traumatology and orthopedics, occurring in athletes. This form of tendonitis affects about 45% of professionals and about 20% of amateurs, who play on average once a week. The likelihood of development increases after 40 years. The patient complains of pain along the outer surface of the elbow joint, often radiating along the outer part of the forearm and shoulder. Gradually increasing weakness of the hand is noted.

Over time, the patient begins to experience difficulties even with simple everyday movements: shaking hands, twisting clothes, lifting a cup. Palpation reveals a clearly localized painful area on the outer surface of the elbow and above the lateral part of the epicondyle. The pain intensifies when trying to straighten the bent middle finger against resistance.

Medial tendonitis

Medial epicondylitis, also known as pronator and flexor tendonitis, or golfer's elbow, develops when the tendons of the palmaris longus, flexor carpi ulnaris, flexor carpi radialis, and pronator teres tendons become inflamed. Medial tendonitis is detected 7-10 times less often than lateral tendinitis.

This disease develops in people engaged in light but monotonous physical labor, during which they have to perform repeated rotational movements of the hand. In addition to golf lovers, installers, typists and seamstresses often suffer from medial epicondylitis. Among athletes, tedninitis is also common in those who play baseball, gymnastics, tennis and table tennis.

The symptoms are similar to lateral tendonitis, but the painful area is on the inside of the elbow joint. When bending the hand and pressing on the area of injury, pain occurs above the inner part of the epicondyle.

Patellar tendonitis

Patellar tendinitis, or jumper's knee, is an inflammation of the patellar tendon. Usually develops gradually and is primarily chronic. Caused by short-term, but extremely intense loads on the quadriceps muscle. In the initial stages of knee tendinitis, pain occurs after exercise.

Over time, pain begins to appear not only after, but also during physical activity, and then even at rest. When examining a patient suffering from tendonitis, pain is detected with active extension of the lower leg and when pressing on the damaged area. In severe cases, local swelling may occur.

Shoulder tendonitis

May affect one or more rotator cuff tendons. The tendons most commonly affected are the supraspinatus and biceps tendons. Isolated lesions eventually spread to adjacent structures with the development of widespread tendinitis of the shoulder joint. At first, the patient experiences pain when moving, then pain occurs at night.

In advanced stages, pain appears at rest, persists for many hours, and intensifies even with movements without the participation of the shoulder joint: bending the elbow, turning the hand, shaking hands. Restriction of movement progresses as the disease progresses. At first, slight stiffness is noted; in the later stages, contractures form in some cases. During periods of exacerbation, swelling is possible. Redness and increased local temperature are rare.

Rehabilitation after treatment of knee tendinitis

Once a patient has been diagnosed with pes anserine tendinitis of the knee joint, the main goal of treatment should be the full restoration of motor activity of the leg.

In this case, it is advisable to use exercise therapy programs aimed at increasing endurance, mobility and flexibility of the lower limb. Rehabilitation experts recommend performing the following exercises:

To increase flexibility in the initial stages of recovery, it is necessary to do static stretches. During this process, it is important to hold one position for 30 seconds. In this case, the ligaments are gradually stretched;
In the future, it is necessary to include dynamic stretching in the treatment complex. These are exercises characterized by active movements. They also help stretch the muscles and help relieve tension in them;
Strengthening exercises for muscles are considered especially effective. They help eliminate tension in the affected area.

An important point is to avoid exercises that increase pain. Some patients use tight bandages and special knee pads, which help realign the position of the kneecap and eliminate tension in the area of nearby ligaments.

If the rehabilitation course is chosen correctly, the patient’s physical activity can be restored in 2-3 months.

How to Treat Achilles Tendonitis

Treatment of heel tendonitis is carried out on an outpatient basis in most cases. Conservative therapy includes the use of the following medications and methods:

Non-steroidal anti-inflammatory drugs;
Immobilization of the injured limb in an elevated position;
Applying irritating ointments to the skin over the heel tendon.

If treatment is ineffective, long-acting glucocorticoids are injected into the soft tissue around the Achilles tendon. Physiotherapists prescribe electrophoresis, ultrasound and electrical stimulation. Acupuncture, myofascial and traditional massage are effective. Rehabilitators select an individual set of exercises for each patient, aimed at stretching and working out the lower leg muscles.

To stretch the calf muscles and Achilles tendon, the patient performs the following exercise:

He stands opposite the wall and leans against it with straight arms;
Places one of the legs in front and the other behind the body;
Performs squats (you must ensure that your feet do not leave the floor);
Crouching as much as possible, he fixes himself in this position for several seconds.

The exercise must be repeated 20 times a day.

Eccentric muscle training is an exercise that involves tensing a muscle while lengthening it. If performed incorrectly, it can cause damage to the heel tendon. The exercise is performed with extreme caution, accompanied by a senior exercise therapy instructor. To perform the exercise, use a ladder. The feet are placed on two adjacent steps. In this case, the heels can move freely down and up. Lower your heels as far as possible and stay in this position for 10 seconds. Repeat the exercise 15 to 20 times. Make the task more difficult by performing the same exercise while standing on one leg or with weights.

When treating tendinitis, specialists help the patient choose orthopedic shoes. It should have a soft back and a small heel. This allows you to reduce tension, thereby reducing the load on the Achilles tendon. For acute pain, patients are advised to wear a support orthosis. If it is missing, you can fix the ankle joint with an elastic bandage, applying a figure-of-eight bandage.

Preventive actions

As you can see, pes anserine tendinitis of the knee is treatable. However, it is easier to prevent the development of this insidious disease than to then waste energy searching for a professional specialist and asking questions like: “How to treat tendinitis of the knee joint?” To do this, you should follow simple rules of prevention. These include:

Avoid prolonged stress on muscles;
Warm up your muscles before starting a sports workout;
Try to get proper rest after any physical activity;
Eliminate any possibility of knee injury;
Try to bend your lower limbs when lifting weights.

By adhering to the above recommendations, you can avoid the development of tendonitis in the left knee joint or prevent the appearance of a pathological process in the right tendon.

Prognosis for treatment of knee tendinitis

If, after detecting tendonitis of the knee joint, the correct treatment is selected, as reviews indicate, dangerous consequences associated with tendon rupture and complete loss of motor activity can be avoided.

According to doctors' forecasts, the likelihood of restoring movements of the knee joint is determined depending on the stage of the pathology:

Stages 1, 2. It is possible to completely restore motor activity through conservative methods;
Stage 3. The possibility of full recovery is difficult;
Stage 4. You can hope for positive dynamics, but surgical intervention is required.

The outcome of treatment can also be predicted depending on the time of its start - the earlier tendonitis is diagnosed, the greater the patient’s chances of restoring tendon function.