Huw David

Tendonitis in the knee joint

Knee Tendon injury - TendonitisLigaments are strong cords of tissue that run from bone to bone and provide stability. Tendons connect the muscle to bone and contraction of the muscle will pull the tendon taut and cause the bone to move. Inflammation of the tendon is called tendonitis. All tendons contain elastic fibres and with age our tendons lose this elasticity. Knee tendonitis is typically seen in those who exercise a lot and with increasing age, but can also arise spontaneously. Some tendons become inflamed more commonly than others. Huw David is a firm believer that prevention is always preferable to cure and warming up properly before sports, stretching exercise and correct footwear are important.

Patella (kneecap) tendonitis* results in pain felt at the lower border of the knee cap where the tendon attaches. Although often referred to as 'Jumpers Knee', it is more commonly seen in runners. Inflammation of the thigh muscle tendon attaching to the upper border of the patella (quadriceps tendonitis) is less common. Inflammation can also affect the structures running along the sides of the knee. Inflammation of the group of tendons (pes anserinus) attaching to the upper, inner aspect of the tibia gives rise to pain felt just below the joint line. The ilio- tibial band is a strong cord like structure passing over the lateral side of the knee joint and may become inflamed as it flicks over the bony prominence at the lower end of the femur over the outside of the knee joint.

Tendonitis gives rise to pain and occasionally swelling and is aggravated by exercise. As with any soft tissue problem, rest, ice and occasionally strapping and use of anti-inflammatories will be appropriate. Physiotherapy including symptomatic treatment, gait analysis and stretching work may be helpful. Occasionally an injection around the inflamed tendon may be advised, but repeated injections are never indicated. Surgery, to remove a bony prominence or to decompress the tendon may occasionally be recommended.

*The patella is an additional (sesamoid bone) bone found within the quadriceps tendon, hence the apparent anomaly of the patella tendon running from bone to bone.