What is knee tendonitis?
The knee joint is comprised of the bones of the thigh and the leg along with several muscles and tendons — tough, fibrous strands of tissue that can tolerate a lot of tension, and which connect muscles and bones. The term tendonitis refers to any inflammation of the tendons. The tendons and the other structures in the knee joint are regularly exposed to various ranges of wear and tear.
The amount of regular usage is generally higher in individuals involved in athletics and certain other sports such as rugby, football or rowing. The tendons of the knee may frequently become inflamed owing to overuse of the knee or trauma involving the knee joint. Such knee injuries are commonly noted in individuals who are involved in different kinds of sports, who are physically very active in a professional context, or in older people. [1]
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Types of knee tendonitis
Some of the specific types of of tendonitis that you might group under "knee tendonitis" (which is itself not a clinical term) include patellar tendonitis (also called jumper’s knee because it's more common in people who jump often), quadriceps tendonitis, and iliotibial band friction syndrome.
Patellar tendonitis or jumper's knee is the most common type of tendonitis of the knee, and it's the kind of tendonitis most likely to be referred to simply as knee tendonitis in some cases. Athletes and others involved in sports such as running, jumping and other movements of the legs that put high pressure on the knees or result in extensive usage of the knee joint are more prone to patellar tendonitis, which is an inflammation of the tendon that links your patella (more commonly called the kneecap) to the tibia or shinbone.
When these structures are exposed to heavy and frequent pressures, it can commonly result in microscopic tears which tend to increase over time and finally resulting in inflammation of the tendons. Knee tendonitis may also be noticed in people living with chronic conditions such as rheumatoid arthritis, which is characterized by inflammation of multiple joints in the body. [2]
Aging, in general, affects the functioning of different parts of the body and may also play a role in the development of knee tendonitis. It has also been noted that knee tendonitis is commonly seen in individuals and athletes in whom the muscles of the knee have been matured to the maximum extent. Trauma or injury to the knee due to a fall or awkward extension of the knee joint may also result in knee tendonitis in certain instances.
What are the signs, symptoms and treatment of knee tendonitis?
The severity and the specificity of the signs and symptoms associated with knee tendonitis may vary with the amount of inflammation in the tendons and the specific tendon involved.
Pain is the most common symptom associated with knee tendonitis, or patellar tendonitis. The severity of the pain a patient with patellar tendonitis may experience is based on the severity of injury to the tendons.
- In mild cases, patients may experience pain only after participating in sports activities or brisk walking.
- In moderate to severe cases of patellar tendonitis, the pain is also present while performing any activities involving the knee joint, such as running or even walking.
- In severe cases, the pain may be severe enough to restrict the affected individual from moving the affected knee. The affected knee joint is also painful to touch and some amount of external swelling may also be visible in some patients. Pain may be noticed in older individuals while climbing or descending stairs. [1,2]
How is knee tendonitis treated?
People who suffer from knee tendonitis (patellar tendonitis) will have a wide number of treatment options at their disposal. The treatment approaches for jumper's knee range from medications to surgery of the knee joints. The treatment is selected based on the extent and severity of the injury to the tendons of the knee.
Doctors may perform extensive diagnostic tests. A physical examination will be the first step, based on the signs and symptoms a patient reports. This alone is often sufficient to diagnose knee tendonitis. Further tests such as MRI scans, ultrasonography, and other advanced imaging techniques may be advised if a severe injury is suspected or to rule out the presence of any other associated conditions of the knee. Imaging techniques will also be performed prior to surgery. [3]
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Mild cases of patellar tendonitis: What treatment can you expect?
- Mild cases of knee tendonitis often recover with adequate rest to the knee and the use of pain-relieving and anti-inflammatory medications. Ibuprofen and other NSAIDs are often recommended for pain relief, as they simultaneously reduce inflammation. This can be sufficient, in combination with rest, for mild acute cases.
- In some cases, intermittent application of ice packs or heating pads to the affected knee joint may also relieve the pain and inflammation of the tendons. However, be careful: when you're first injured, ice is a better choice than heat — especially for about the first three days or so, because applying ice will numb your pain and cause blood vessels to constrict, which will help reduce swelling. However, after the first three days, you will benefit more from heat application to alleviate your chronic tendinitis pain, because heat increases blood flow to an injury, which may help promote healing. Heat also relaxes the surrounding muscles, which promotes pain relief.
- Physiotherapy, which involves specific exercises to strengthen the muscles and tendons of the knee, will also advised.
- Stretching exercises and squatting exercises (following the reduction in the symptoms) are advised to improve knee function and mobility and also to strengthen the knee to prevent further injuries.
- Young adults with knee tendonitis are often advised to perform exercises such as lunges, squats and leg presses to strengthen the knee joints.
If you suspect you have patellar tendonitis but have not been diagnosed, do seek medical attention before starting an exercise regime!
Mild to moderate patellar tendonitis: What to do?
- Mild to moderate cases may require additional treatment such as splinting the knee joint to restrict the movement of the knee joint and thereby prevent undue stress on the knee joint, allowing it to heal.
- Injection of steroid medications near the affected knee joint may be required if the symptoms persist even after following the above mentioned simple approaches.
Severe cases of patellar tendonitis: What can you expect?
Severe cases of jumper's knee, which do not respond to any other treatment or management approaches, may require surgery to repair any ruptured or torn tendon.
Following a surgery of the tendons, individuals are generally advised a few weeks of rest during which they should restrict the movement of the knee. After a few weeks, physiotherapy is started to enable the affected individual to return to normal activities in a gradually phased manner.
In case of athletes, complete recovery and return to sports may require more than 3 months time following surgery.
How can you prevent knee tendonitis?
As processes such as increasing age cannot be changed, following certain preventive measures can be helpful in preventing knee tendonitis. Participation in sports is not a problem — but following proper physiotherapy techniques and warm up procedures can prevent the occurrence of knee tendonitis. [4]
Early identification of knee tendonitis and prompt treatment can prevent it from becoming severe enough to restrict day to day activities.
The muscles, tendons and other parts of the body need to be warmed up before beginning any activity that involves the continuous use of the joints. Simple warming and stretching exercises are necessary before getting started with any kind of sport activities. This helps to improve blood circulation and enables the muscles to get ready for the higher stresses associated with strenuous physical activity.
Stretching and squatting exercises are often beneficial in strengthening the knee joints and can thereby help prevent knee tendonitis.
Continuous sitting or standing for prolonged periods may also put undue pressures on the knees, making them prone to knee tendonitis. Intermittent walking or stretching the knee joint and the legs can be beneficial in improving the muscle health.