Knee Tendonitis

Knee tendonitis is a an injury due to inflammation or irritation of the knee tendons and causes pain, swelling, tenderness and stiffness of the knee. This typically occurs as an overuse injury and actually covers four possible sub types of tendonitis. The typical symptoms of knee tendonitis are pain, stiffness and swelling of the knee, usually in the region of the injured tendons. Mild to moderate cases of this injury are treatable using the R.I.C.E. approach (rest, icing, compression and elevation). Your doctor may also suggest non steroidal anti inflammatory druds (NSAIDs) to relieve pain and inflammation if they are severe. Cortisone injections may also be used. If the condition is persistent and resists conservative treatment, surgery is another option.

What Types Of Knee Tendonitis Are There?

The term “knee tendonitis” is actually an umbrella expression that covers four different sub-types of tendonitis:

• Patellar tendonitis affects the patellar tendon that connects the kneecap (patella) to your shinbone. The point of attachment is just below the patella. This tendon plays a key role in knee extension movements, which in turn are key to the acts of jumping and running. Patellar tendonitis is the most well known type of knee tendonitis, although it is not the most common form.
• Pes anserinus tendonitis affects the pes anserinus tendons that sit just below the knee and on its medial (inner) side. These tendons prevent your lower leg from twisting outward while you run. Pes anserinus tendonitis is one of the most common forms of knee tendonitis, although it is not particularly well known.
• Semimembraneous tendonitis affects one of the three pes anserinus tendons we have mentioned above.
• Popliteus tendonitis affects the popliteus tendon that sits behind the knee. The role of this tendon is to assist in the leg flexion movements.

Causes

Each of the types of knee tendonitis we have listed above has a somewhat different cause:

• Patellar tendonitis tends to be the result  of excessive running and jumping activity;
• Pes anserinus tendonitis usually occurs among middle aged individuals if they over stress the pes anserinus tendons by excessive running;
• Popliteus tendonitis is usually a result of excessive inward roll of your feet (pronation). It is also brought on by extensive running on a downhill slope.

Symptoms

Knee tendonitis symptoms usually include some or all of the following:

• Pain in the region of the affected tendon, as well as tenderness and stiffness of the joint.
• For patellar tendonitis, the pain is usually at the front of the knee. For pes anserinus or semi membraneous tendonitis, it usually occurs on the inside of the knee joint and (in the case of the latter) behind it. In cases of popliteus tendonitis, the pain is usually felt behind the joint.
• The pain, tenderness and stiffness are usually more severe during movement and tend to reduce during periods of rest. Other activities that aggravate the pain may include climbing or descending stairs or rising from a seated position. You may also experience more pain at night time.
• In some cases, you may experience slight knee swelling due to the accumulation of fluid and inflammation in the sheaths of the injured tendons.

Treatment Of Knee Tendonitis

The majority of knee tendonitis cases fortunately react positively to conservative approaches to treatment. Accordingly, your doctor will likely start by suggesting an R.I.C.E. approach:

• Resting your knee by refraining from athletic activities like running for a period and keeping your weight off the joint as much as possible. This will allow the injured tendons a chance to recover naturally.
• Applying ice or a cold compress to your knee frequently(e.g. for periods of 20-30 minutes every 3 hours or so). If you are experiencing severe pain, your doctor may also suggest using non steroidal anti inflammatory medications for additional control of pain and inflammation;
• Applying compression to your knee joint by wearing a tensor bandage or knee sleeve;
• Keeping your knee above heart level as much as possible when you are lying or sitting down.

If the knee tendonitis does not respond to these approaches, your doctors may consider cortisone injections. However, you should only consider this treatment if your doctor is sure it is necessary. Cortisone injections into the tendon can actually cause it to deteriorate and cause the injury to become long term and chronic in nature.

Surgical Treatment

If the above conservative treatments do not help, your doctor may suggest referring you to a surgeon. As with cortisone injections, you should approach this step with caution as it can have unintended side effects. Be sure to thoroughly discuss its pros and cons (especially the latter) with your surgeon before agreeing to undergo surgical intervention. And do not be afraid to get a second opinion if you think it may help.