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Knee tendonitis

Find out about knee tendonitis, how it's diagnosed and the treatments available

Patient with knee tendonitis is being examined by an orthopaedic specialist
Strong bands of connective tissue, called tendons, connect your muscles to your bones. Should a tendon become inflamed or irritated, it is referred to as tendonitis. 

Tendonitis can occur in any tendon in the body. The most common cause of tendonitis is the overuse of muscles. This overuse is often due to repetitive movements, such as those used in sports like golf, tennis or swimming.  

However, tendonitis can also occur suddenly if a serious and abnormal load or weight is applied to the tendon. 

Your knee is the largest and most complex joint in your body. It is made up of knee ligaments, tendons and bone. The knee sits between the femur and tibia bones (thigh and shin bone). When a knee tendon injury occurs it can significantly affect your ability to use your leg normally.  

Should you be experiencing pain, inflammation, swelling or discomfort in your knee, assessment, diagnosis and advice on treatment from an orthopaedic consultant is advised.

Knee tendonitis is actually an umbrella term that covers several types of knee tendonitis. These include patellar tendonitis, quadriceps tendonitis and iliotibial band friction syndrome.  

The largest tendon in your knee is known as the patellar tendon. It takes it name from the kneecap (patella). This tendon runs over the front of your knee. It connects your shinbone (tibia) with the large muscles of your upper thigh (quadriceps).  

The patellar tendon helps your leg muscles to extend your knee, providing important leg movements such as jumping and kicking. 

This tendon can easily become inflamed as the result of repetitive stress on the knee. This knee tendon pain is called patellar tendonitis. It is the most common type of tendonitis in the knee.  

Patellar tendonitis is often caused by overuse in sports that involve running as well as jumping, hence the reason why it is also called jumper’s knee.  

During a sports activity, the repetitive stress placed on the knee creates tiny tears in the tendon. Over time, these tiny tears become inflamed and weaken the tendon. This sports injury eventually results in the pain caused by knee tendonitis. 

There are several contributing factors that can increase the likelihood of knee tendonitis. These include: 

· Tight muscles in the leg 

· Uneven strength in the leg muscles 

· Misaligned feet, ankles and legs 

· Obesity 

· Shoes that don’t have enough padding in the soles. 

· Playing sports on hard surfaces, such as a squash court. 

· Chronic diseases that weaken the tendon over time 

Athletes are generally more at risk of knee tendonitis because running, jumping and squatting places more force on the patellar tendon.  

While the nature and severity of symptoms will vary from person to person, the most common symptom of knee tendonitis (or patellar tendonitis as it is also called) is pain and swelling towards the bottom of the kneecap.  

This pain may only be felt intermittently but as the tendonitis worsens the pain is likely to become more constant and more limiting.  

Certain movements, such as kneeling or climbing stairs may cause the pain to increase. You may find that you also experience some swelling around your knee. 

Patellar tendonitis can usually be managed and treated without need for surgery and in most cases you should expect to feel improvement within a couple of weeks of rest. Some simple stretches for knee tendonitis will also help to alleviate the symptoms caused by tendon damage in knee. 

If your pain is more severe, or continues for longer, assessment by a consultant would be advised to help accurately determine the extent of the knee tendonitis and of any damage to the tendon. 

Pain cause by patellar tendonitis can usually be treated effectively using one of the following methods: 

· Ice: A cold ice pack on the affected knee may help to reduce the swelling and pain of a torn tendon in knee. 

· Medication: Painkillers, particularly non-steroidal anti-inflammatory medications (NSAIDs) such as aspirin or ibuprofen, can help to relieve pain and reduce inflammation. 

· Physical therapy: Your consultant may recommend that you see a physiotherapist for help. If the tendonitis in your knee has been caused by overuse, a physiotherapist will be able to help show you alternative ways to carry out certain movements, in order to lower the risk of experiencing tendonitis again. These knee tendonitis exercises can be particularly helpful for sportspeople, who are often required to perform the types of repetitive movements that can increase the risk of tendonitis. It is advisable to wear knee support for tendonitis, such as a patellar tendon knee strap, while exercising. 

· Rest: Sometimes, the best thing you can do to aid recovery from tendonitis in your knee is to rest your leg. While this may appear impractical, rest can promote healing as well as remove the risk of putting any additional strain on the affected tendon by mistake. 

· Platelet Rich Plasma (PRP) injection: This form of platelet therapy uses an individual’s own healing system to encourage healing. This involves injecting plasma taken from the patient’s own blood platelets directly into the knee for speedy pain relief. 

In more severe or long-term cases of tendonitis, you may be advised to have surgery. Long-term tendonitis in the knee can sometimes lead to a tear/rupture of the tendon; if this occurs, surgery will probably be required to repair the damage.  

Following the procedure, you will be prescribed a course of physiotherapy to help you to recover and return to normal levels of activity. 


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