Knee Tendonitis Treatment and Rehabilitation

What is knee tendonitis?

Knee tendonitis refers to the inflammation of the tendons of the knee joint. Commonly noted in athletes, this condition is associated with pain and restricted mobility of the knee joint. Swelling and redness of the knee joint may also be noted in certain cases. Patellar tendonitis (also called ‘jumper’s knee’), quadriceps tendonitis, and iliotibial band friction syndrome are a few of the specific types of knee tendonitis that commonly affects sports individuals. Knee tendonitis commonly occurs due to overuse or injury to the knee joint. Athletes involved in sports such as high jump are more commonly affected by this condition wherein repeated jumping can injure the knee joint. Other sports which involve running and jumping are also the common risk factors of knee tendonitis.  

How is knee tendonitis treated?

The treatment of knee tendonitis is based on the severity and duration of the condition. While acute cases that are noted immediately following severe strain or trauma can be treated with non surgical methods, long standing conditions or rupture of the muscles may require surgery to rectify the problem.

General measures

Application of ice at frequent intervals can reduce the amount of inflammation associated with the trauma. Pain relieving medications may be required if the pain is severe. Adequate rest to the knee joint is necessary when the symptoms of pain and inflammation are quite severe. Physiotherapy may also be advised to release the strain caused in the muscles around the knee joint. Certain stretching and strengthening exercises to reduce pain, improve flexibility, and strengthen the knee muscles and ligaments are included in the physiotherapy procedures. 

Mild to moderate knee tendonitis

In mild to moderate cases of knee tendonitis splinting may be required for certain duration of time to rest the knee joint and allow the injured tissues to heal. Following this, physiotherapy is advised to strengthen the knee joint and return to sport or regular activities.

Severe knee tendonitis

In severe cases or long term conditions with gross injury to the joint or severe tear of the muscles, surgery may be advised to correct the defect. The surgical procedures involve opening up the knee joint and identifying and rectifying the muscle tear. Sutures are placed to join the torn muscles and ligaments and are left in place for a few weeks. Splinting of the knee joint for a few weeks is advised following surgery. Physiotherapy is advocated after a few weeks of splinting. The physiotherapy or the rehabilitation procedures help the affected individual to regain the strength in the knee joint and gradually resume day to day activities. Return to sport requires a thorough evaluation of the injury and clearance from the surgeon. Adequate amount of rest, rehabilitation and sports specific training is necessary before return to sports and participation in competitions. The time period required for the athlete to return to sports following surgical correction may span for a few months.

Rehabilitation for knee tendonitis

Rehabilitation of the knee joint is advised following symptomatic treatment of the pain associated with knee tendonitis and also following surgical treatment (to correct the muscle or tendon tears). The aim of the rehabilitation therapy is to strengthen the muscles of the knee to aid in the return of the normal function of the knee joint and prevent further injuries. Proper rehabilitation therapy is highly essential for early recovery from the injury, return to normal function and also to improve the function of the knee joint. Inadequate amount of rehabilitation can hamper the flexibility of the knee joint and prevent the athlete from performing well in sports. Early initiation of rehabilitation therapy is also important to prevent the progression of knee tendonitis.

In case of mild to moderate types of knee tendonitis stretching and strengthening exercises aimed at improving the function of the knee muscles are advised. Stretching of the quadriceps and hip flexor muscles are initially advocated. Following this strengthening exercises are performed. The strengthening exercises can include lunges, squats and leg presses.

Warm up exercises are always advised in order to improve the blood flow and muscle compatibility.

Following adequate recovery, sport specific training is initiated to aid in the return to sports. Sports’ training involves exercises aimed at improving the range of motion of the knee joint, strengthening the muscles of the legs and enhancing muscle flexibility.

Rehabilitation exercises for knee tendonitis

Some of the specific types of exercises that are advised during the rehabilitation phase have been discussed below. While some of these exercises are advised to relieve pain others are advised to increase the flexibility and strength of the muscles.

Hamstring stretch

This exercise is aimed at strengthening the hamstring which is a tendon present at the back of the knee. Usually standing exercises are advised to stretch and improve the flexibility of the hamstring. Improving the flexibility of the hamstring has been found to be beneficial in preventing further injuries.

Quadriceps stretch

The quadriceps is the muscle of the thigh that helps in the extension movement of the leg. Stretching this muscle improves the flexibility, reduces pain and improves the function of these muscles. Improving the flexibility of the quadriceps muscle reduces the risk of further injuries to the knee joint.

Leg raises and step up exercises

These exercises are aimed at improving the endurance of the muscles and also improve the strength of the leg muscles.

Strength and endurance exercises

Eccentric squats using a decline board is generally advised to strengthen the quadriceps muscles. Improving the strength of the muscles increases the ability of the muscles to handle stress associated with repeated use. Decline squats are also advised in certain instances

Plyometrics

This refers to the study of the technique used by the athlete while participating in sport and correcting the steps that may be increasing the risk of injury. Increasing the speed or force of muscle contractions is another aim of plyometrics.

Agility exercises

Exercises performed with the use of a skipping rope to improve the agility of the leg muscles and also the coordination of the leg movements is frequently advised. Skipping rope can also be used for warm up sessions.