Patella tendonitis treatment. Tendinitis of the patellar tendon: treatment at home Treatment of calcification of the patellar ligament

Smetanin Sergei Mikhailovich

traumatologist - orthopedist, doctor medical sciences

Moscow, st. Bolshaya Pirogovskaya, 6., bldg. 1, metro station Sportivnaya. Registration strictly by phone!!!

Write to us on WhatsApp and Viber

Education and professional activities

Education:

In 2007 he graduated with honors from the Northern State Medical University in Arkhangelsk.

From 2007 to 2009, he completed clinical residency and correspondence postgraduate studies at the Department of Traumatology, Orthopedics and Military Surgery of the Yaroslavl State Medical Academy on the basis of an emergency hospital medical care them. N.V. Solovyova.

In 2010, he defended his dissertation for the degree of Candidate of Medical Sciences on the topic "Therapeutic immobilization of open fractures of the femur" . Scientific supervisor - Doctor of Medical Sciences, Professor V.V. Klyuchevsky.

Professional activities:

From 2010 to 2011 he worked as a traumatologist-orthopedist at the Federal State Institution "2nd Central Military Clinical Hospital named after P.V. Mandryk".

Since 2011, he has been working in the clinic of traumatology, orthopedics and joint pathology of the First Moscow State Medical University. THEM. Sechenov (Sechenov University), being an associate professor at the Department of Traumatology, Orthopedics and Disaster Surgery.

Conducts active scientific work.

Internships:

April 15-16, 2008 JSC course "AO Symposium Pelvic Fractures" .

April 28-29, 2011 - 6th educational course "Problems in the treatment of common fractures of the bones of the lower extremities" , Moscow, State University of Monika named after. M.F. Vladimirsky.

October 6, 2012 - Atromost 2012 "Modern technologies in arthroscopy, sports traumatology and orthopedics" .

2012 - training course on knee replacement, prof. Dr. Henrik Schroeder-Boersch (Germany), Kuropatkin G.V. (Samara), Yekaterinburg.

February 24-25, 2013 - training course "Principles of total hip replacement"

February 26-27, 2013 - training course “Basics of total hip replacement” , Federal State Budgetary Institution "RNIITO im. R.R. Harmful" Ministry of Health of Russia, St. Petersburg.

February 18, 2014 - workshop on orthopedic surgery "Endoprosthetics of the knee and hip joints" ,Dr. Patrick Mouret, Klinikum Frankfurt Hoechst, Germany.

November 28-29, 2014 - training course on knee replacement. Professor Kornilov N.N. (RNIITO named after R.R. Vreden, St. Petersburg), Kuropatkin G.V., Sedova O.N. (Samara), Kaminsky A.V. (Kurgan). Subject "Course on ligament balance in primary knee replacement" , Morphological Center, Yekaterinburg.

November 28, 2015 - Artromost 2015 "Modern technologies in arthroscopy, sports traumatology, orthopedics and rehabilitation" .

May 23-24, 2016 - congress "Emergency medicine. Modern technologies in traumatology and orthopedics, education and training of doctors" .

May 19, 2017 - II Congress "Medicine" emergency situations. Modern technologies in traumatology and orthopedics.”

May 24-25, 2018 - III Congress “Emergency Medicine. Modern technologies in traumatology and orthopedics.”

Annual scientific and practical conference with international participation “Vredenov Readings - 2017” (September 21 - 23, 2017).

Annual scientific and practical conference with international participation “Vredenov Readings - 2018” (September 27-29, 2018).

November 2-3, 2018 in Moscow (Crocus Expo, 3rd pavilion, 4th floor, 20th hall) conference"TRAUMA 2018: A multidisciplinary approach."

Associate member of the InternationalNational Society of Orthopedic Surgery and Traumatology (SICOT - French Société Internationale de Chirurgie Orthopédique et de Traumatologie; English - International Society of Orthopedic Surgery and Traumatology). The society was founded in 1929.

In 2015, he was awarded the gratitude of the rector for personal contribution to the development of the university .

From 2015 to 2018 was an applicant at the Department of Traumatology, Orthopedics and Disaster Surgery of the Medical Faculty of Sechenov University, where he studied the problem of knee replacement. The topic of the dissertation for the degree of Doctor of Medical Sciences: "Biomechanical substantiation of knee arthroplasty for structural and functional disorders" (scientific consultant, doctor of medical sciences, professor Kavalersky G.M.)

Protection dissertation work took place September 17, 2018 V dissertation council D.208.040.11 (Federal State Autonomous Educational Institution of Higher Education First Moscow State medical university named after I.M. Sechenov Ministry of Health of Russia (Sechenov University), 119991, Moscow, st. Trubetskaya, 8, building 2). Official opponents: doctor of medical sciences, professors Korolev A.V.,Brizhan L.K., Lazishvili G.D.

He is a doctor of the highest qualification category.

Scientific and practical interests: endoprosthetics of large joints, arthroscopy of large joints, conservative and surgical treatment injuries of the musculoskeletal system.

Anatomy of the patellar ligament

The patellar ligament is anatomically a strong cord that runs from the lower pole of the patella to the tibial tuberosity. The ligament plays a key role in the biomechanics of the knee joint. The patellar ligament, also known as its own ligament, is a continuation of the extensor apparatus, formed first by the quadriceps femoris muscle, then by the patella and the patellar ligament itself.

1- femur

2 - quadriceps tendon

3 - superior inversion of the knee joint

4 - patella

5 and 6 - fatty bodies of the knee joint

7 - anterior cruciate ligament

8 - posterior cruciate ligament

9 - patellar ligament

10 - tibia

When the quadriceps muscle is tense, the patella moves upward, and behind the patellar ligament itself, extension occurs in the knee joint, raising the straightened leg. The points of attachment of the ligament experience the greatest stress and deformation, and not its middle part, therefore there are more separations of this ligament than ruptures. The patellar ligament is very strong, and the damaged ligament usually ruptures or is torn off. Typically, the rupture of the patellar ligament is preceded by its tendinitis, that is, aseptic inflammation.

Symptoms of a torn patellar ligament

Typical mechanism of injury to the intrinsic ligament:

• powerful contraction of the quadriceps muscle when pushing, lifting,
• sometimes you can hear a crunching, crackling sound,
• there is a sharp pain,
• movement in the knee joint becomes impossible.

With these complaints, you should urgently consult a doctor.

The traumatologist will look at the knee joints, palpate the knee joint, and can determine hemarthrosis, that is, blood in the knee joint. When the ligament is completely ruptured, the patella moves upward due to the traction of the thigh muscles, and extension in the knee joint becomes impossible. In some cases, you can palpate the hole in the place where the patellar ligament should be.

Diagnosis of patellar ligament injuries

X-rays of the knee joint are helpful in diagnosing rupture and damage to the patellar ligament, which can rule out other injuries, especially fractures. On the lateral view, the patella is higher than on the healthy leg. This is a 100% diagnosis of patellar ligament rupture. Sometimes the ligament comes off with a piece of bone - either the lower pole of the patella or the tibial tuberosity. Ultrasound of the knee joint or MRI is also useful for diagnosis.

X-ray of the knee joint, lateral projection - the patellar ligament is intact, the patella is in a typical place

Avulsion of the patellar ligament with upward displacement of the patella due to traction of the quadriceps femoris muscle

Treatment of patellar ligament rupture

To fully restore your own ligaments, surgery is necessary.

Conservative treatment of patellar ligaments does not bring results. Moreover, it is advisable to perform the operation as early as possible, this will lead to better result. During operations, the traumatologist finds the ends of the torn patellar ligament and sews them together. Sometimes the ligament is additionally strengthened with absorbable or synthetic materials. Exists huge amount techniques, but their meaning is to stitch the ligament, restore its length and strengthen it.

After kneecap surgery, the leg is immobilized in a straight position with a cast or orthosis. An orthosis is preferred because it is possible to adjust the angle of flexion in the knee joint and to carry out early development of movement in the knee joint, since active development has been proven to accelerate the fusion of the ligament.

The prognosis is usually favorable. The main thing is to perform surgery as early as possible.

Knee movement and stability are possible thanks to the coordinated work of its five ligaments:

• two cruciform,
• two lateral
• own patellar ligament.

In addition to the unpleasant situations associated with direct injury to the knee (torn ligaments, dislocation or fracture), another danger arises - tendonitis of the knee joint (inflammation of the tendons and ligaments). The most common diagnosis is tendonitis of the patellar tendon.

Anatomy of the patellar ligament

The ligament propria continues the quadriceps femoris tendon and attaches it anteriorly to the tibial tubercle located below the kneecap.

This original structure makes the knee joint unique: it not only provides motor functions, but also works on the principle of a lever-block mechanism, multiplying the efficiency of the quadriceps muscle:

Causes of knee tendonitis

Knee tendonitis is caused by either mechanical or degenerative causes.

Tendinitis of mechanical origin

The first type (mechanical) is associated with sports or professional activities:

• Constant training or stress leads to microtrauma of the ligament and the appearance of inflammatory process.
• Patellar tendonitis is most often diagnosed in athletes involved in jumping sports, which is why this pathology has received a very accurate name - jumper's knee.

The greatest tension always appears at the place of attachment of the ligament, and, consequently, tendinitis develops mainly at the place of its fixation to the patella or the tibial tubercle (the first is more common). Thus, it is more appropriate to consider it not tendinitis, but enthesitis.

Precipitating factors for tendinitis are:

• flat feet with the foot falling inward (pronation);
• the anatomical position of the kneecap, in which the ligament is pinched by it when the knee is bent above 60°;
• impaired knee stability with rotation of the femur and tibia;
• Hamstring syndrome - injuries due to constant stress on the muscles of the back of the thigh.

Degenerative tendinitis

The second type of tendinitis is age-related and is associated with aging of the ligaments and degenerative changes in them:

• mucoid process or fibrosis predominates;
• pseudocysts appear.

Ligament degeneration can be caused by:

• rheumatoid arthritis;
• infectious arthritis;
• diabetes mellitus;
• long-term use of glucocorticosteroids and other reasons.

In a weakened ligament, the process of regeneration simultaneously occurs - the restoration of degeneratively changed areas:

• restored areas are denser and larger;
• angiofibroblastosis is possible in them;
• Ossification (ossification) and calcification of the ligaments may be observed - this property is observed in both types of tendinitis.

Stages of knee ligament tendinitis

Knee tendinitis goes through four stages:

• The first is that symptoms of discomfort and pain occur only after training or exertion.
• Secondly, the above symptoms are possible both before and after the load.
• The third is pain symptoms during the exercise itself and after it.
• The fourth is a ligament rupture.

The rupture occurs naturally: chronic inflammation in the ligament leads to its structural changes, reducing mechanical strength. If the rupture did not occur due to a normal injury, but due to tendonitis, then it is considered a complication of tendonitis.

Symptoms of knee tendinitis

• Tendonitis of the patellar tendon begins initially with mild, dull pain in the lower part of the kneecap or in the area of ​​the tibial tubercle.
• On early stage The pain occurs mainly after exercise.
• There may also be a feeling of tension or stiffness, and it may be difficult to straighten the knee.
• As the pain progresses, it becomes more intense until it begins to accompany all flexion and extension movements.
• If tendinitis affects the deep layers, then with strong and deep pressure on the area between the kneecap and the tibial tubercle, pain occurs.
• A symptom of partial or complete rupture of the ligament is pain when extending with resistance.

Diagnostics

To clarify the diagnosis, an x-ray of the knee is taken: frontal and lateral projection.

X-rays can reveal fatigue microtraumas, areas of ossification and calcification.

Please note that knee pain can occur for many reasons:

• damage and rupture of the meniscus;
• osteochondropathy of the patella;
• enlarged tubercle of the tibia.

A closer look at localized areas of the ligament or meniscus may require precise examination using computed tomography or magnetic resonance imaging.

Knee tendinitis: treatment methods

In the first two stages, conservative treatment is used:

1. They facilitate training and load regimes, reducing the intensity of training or work.
2. Ice compresses are applied.
3. To reduce pain, non-steroidal anti-inflammatory drugs (ibuprofen, indomethacin, naproxen) are used orally or intramuscularly.

It is better not to use intra-articular local injections of NSAIDs or glucocorticosteroids for knee tendonitis, as they contribute to the development of ligament atrophy.

All these drugs give a temporary effect and have a lot of side effects, especially for the gastrointestinal tract.

The main method of treating knee tendonitis is exercise therapy with exercises for hyperextension and strengthening of the quadriceps and posterior muscles.

They take a long time to perform (sometimes several months), but the effect of the exercises is very good - they allow you to cure tendinitis and resume training or work in full mode.

Another type of conservative non-drug treatment is taping.

Taping for knee tendonitis

The point of taping is to use special tapes that relieve the ligament.

Eat various types taping:

• the tape is glued across the ligament;
• cross-shaped with fastening at the top or bottom;
• along the ligament with fixation below the tibial tubercle, to which the patellar ligament is attached;
• combined taping (for example, cruciform and longitudinal, cruciform and transverse).

Just like taping, wearing orthoses helps to relieve the knee ligament, but it is not placed directly on the kneecap, but a little lower.

Surgical treatment

Grade 3 or 4 knee tendonitis is difficult to treat conservatively and may require surgical treatment.

Arthroscopy is often used, a method in which an instrument is inserted through small punctures under the supervision of a microscopic video camera and the damaged areas are removed. In this way it is possible to delete:

• minor ligament damage;
• growths on the kneecap if they impinge on the ligaments.

Cysts and other formations require open surgery.

Types of open operations:

• excision of the ligament;
• scraping the lower part of the kneecap;
• multiple tenotomies on ligaments (notches).

But these methods can lead to weakening and rupture of the ligament in the future. At the fourth stage, the preferred operation is plastic reconstruction.

Sometimes surgeons resort to other types of operations:

• resection of the lower pole of the patella, if it is considered to be the culprit of chronic knee tendinitis;
• removal of the fatty body (Hoffa) located under the patella.

Exercise therapy: examples of exercises for knee tendinitis

These exercises are very effective for knee tendonitis:

Quadriceps stretching exercises:

• Turning your back to the table or cabinet and holding the back of the chair, place right leg on the table. We maintain balance for 45 - 60 seconds, feeling the tension on the front surface of the thigh. We repeat the exercise with the left leg.
• You can slightly modify the exercise by not placing it on the table, but holding the foot from behind with your hand.
• Sitting on the floor, lean back, leaning on your elbows behind you. We bend one leg at the knee, and raise the other straightened one and hold it for some time. Then change the position of your legs and repeat the lift.
• Isometric exercise (with severe pain):
  • Sit on the floor with your legs straight, hands resting on the floor behind you.
  • Tighten the leg muscle, pulling the kneecap towards you (the leg remains motionless).
  • Hold this position for a few seconds, then relax and repeat with the other leg.
  • Perform 20 times in several approaches.
• Resistance exercises (performed with a resistance band or resistance band):
  • The leg bent at the knee is fixed with tape. We straighten the knee, overcoming resistance.
  • Other options: moving the leg back with resistance, to the side, swinging the leg.

Exercises for the posterior thigh muscles:

• While standing in front of a table (gymnastic ladder), place your foot on the surface or bar and reach with your hands towards your foot without bending the other leg.
• While sitting on the floor, bend alternately towards the soles of your spread legs.

Video: Self-healing knee tendinitis.

Tendinitis of the patellar tendon is a diagnosis that inspires fear in many patients. The patellar ligament (Patellae proprium) is an important participant in the movement process, responsible for straightening the leg at the knee joint. Anatomically, this fibrous structure is attached to the tibial tuberosity on one side and to the lower edge of the patella on the other.

Etiology of tendinitis

Doctors from the field of sports medicine know Patellae proprium, since this injury accompanies professionals in sports and is called “jumper’s knee”. Chronic loads on the knee area during long-term training are typical for such types of movement as intense running, jumping, and sudden acceleration and braking. These “provocateurs” of inflammation are inherent in the following sports areas:

• football;
• cycling;
• sprint;
• tennis;
• volleyball;
• boxing;
• basketball.

Factors contributing to the development of pathology:

1. Flat feet, in which the foot “falls” inward, increases the tension of the ligament due to the “twisting” of the lower leg.
2. Insufficient shock-absorbing properties of the surface where training takes place.

The second risk group for tendonitis is elderly people who may develop a degenerative process in the osteoligamentous apparatus of the knee. Increasing age of patients leads to the following changes in Patellae proprium:

• a decrease in its flexibility;
• elasticity;
• decreased ability to adequately respond to stress.

As a result of minor household injuries, microcracks may appear. Microtrauma to the ligament against the background of metabolic disorders and concomitant joint diseases quickly turns into inflammation with a predominance of degenerative changes.

It should be noted that the term “elderly people” in relation to Patellae proprium tendinitis is determined not so much by age as by the condition of the articular and ligamentous apparatus. If the biological age is ahead of the actual age, then tendinitis is very likely to occur in people starting from 45 years of age.

Tendinitis Patellae proprium manifests itself primarily as pain. Patients complain that the knee pad hurts and the knee aches. Painful sensations more often localized in the apex, less often in the area of ​​the tibial tuberosity.

The development of the disease undergoes three stages:

1. At first, the pain is almost unnoticeable and is provoked by heavy loads on the knee joint, more often in the evening, activity is preserved.
2. The pain appears with normal activity.
3. Pain can occur even at rest.

If they join painful sensations along the entire patellar ligament, accompanied by tissue swelling - this is a likely sign of tendovaginitis. Patients also complain of joint stiffness and weakness in the knee.

Important! Patellar tendonitis is often complicated by rupture.

Diagnostics

A history of the disease, taking into account the patient’s profession, helps the specialist to suspect inflammation of the patellar ligament at the very beginning of the examination. Instrumental diagnostic methods that are used to determine the diagnosis:

1. X-ray in frontal and lateral projections - to identify fractures and foci of calcification in the Patellae proprium.
2. MRI – helps to exclude damage to other soft structures of the knee joint (menisci).
3. Ultrasound examination - to detect ligament compaction, signs of degeneration, ruptures.

Palpation examination of the areas of fixation Patellae proprium reveals pain. Extending the knee against resistance also causes pain.

Conservative therapy

In the first, second stage and at the initial stage of the third stage, as a rule, damaged structures respond well to the following conservative methods of therapy:

1. Cooling the damaged area with ice (compresses).
2. Limiting sudden movements, reducing any stress on the ligament.
3. Developing and following a quadriceps strengthening program.
4. Massage.
5. Physiotherapy.
6. The use of orthoses (special bandages), taping.

Kinesio taping involves the use of special tapes that in different ways are glued to the damaged area, unloading the Patellae proprium.

A course of non-steroidal anti-inflammatory drugs. These drugs do not affect the etiopathogenetic mechanisms of the disease, but can relieve symptoms. The duration of use should not exceed seven days. In elderly patients with concomitant diseases digestive tract Before using NSAIDs, it is necessary to evaluate the possible benefits of taking them and the risks of damage to the gastrointestinal tract.

Surgical treatment

Methods surgical treatment tendonitis can be different, it all depends on the degree of injury.

Arthroscopy

If ineffective conservative treatment or a ligament rupture has already occurred, the damaged tissue is removed. More often, arthroscopic techniques are used for this as a minimally invasive method, less often - open access. The choice of approach is determined by which area of ​​the ligament is damaged.

For example, the formation of cysts in the thickness of the ligament is an indication for open surgery. Open surgery compared to the endoscopic technique is a more traumatic method, leading to an increase in the recovery period.

Curettage

It is possible to provoke the restoration of one’s own tissues by performing curettage (curettage) of the lower part of the patella. In addition, the following manipulations are prescribed:

1. A frequent intervention is resection of the lower edge of the patella to eliminate ligament entrapment.
2. It is also possible to excise the ligament - partial or wide, after which the edges of the ligament are fixed.

Carrying out these surgical interventions, unfortunately, does not always allow for effective treatment of the patient: in the future, relapse of the disease is possible and.

Important! Timely reconstruction can completely restore the function of the quadriceps (quadriceps femoris muscle). Delaying surgery by a month significantly reduces the likelihood of a successful outcome.

Prevention

Diseases of the patellar ligament can be avoided if the following conditions are constantly met:

1. Physical activity can only be increased and decreased gradually.
2. Before execution physical exercise it is necessary to “warm up” the joints and ligaments.
3. Choose the “right” places to play sports and the “right” training methods.
4. Balanced work and rest regime.
5. Harmonious load on all joints, eliminating long monotonous repetitions of movements in one joint.

Timely treatment of concomitant diseases of the musculoskeletal system and healthy image life are also preventive techniques.

When the tendon connecting the tibia and the patella is inflamed, tendonitis of the patellar tendon is diagnosed. As the disease develops, the patient feels stiffness when bending and straightening the leg: it becomes painful to play football, ride a bicycle, or simply walk. The disease can be cured if it is identified in a timely manner and a set of immediate measures is taken.

Causes of the disease

Doctors say the main factors in the occurrence of the disease are injuries and age. Inflammation of the ligaments due to regular microtraumas is typical for athletes and people whose activities involve heavy physical labor that places hyperstress on the knees. Sprains, bruises, and dislocations lead to the development of inflammatory processes in the leg, creating the ground for the appearance of pain.

Also, the patellar ligament is deformed and destroyed over time, which is why tendoperiostopathy and tendinopathy often occur in older people. With age, the body weakens and is unable to effectively fight inflammation on its own. The onset of tendon disease due to weakened immunity is observed in pregnant women, especially when before conception expectant mother led active image life and had a number of sports knee injuries.

Symptoms and manifestations

Like other joint diseases, patellar tendinitis has symptoms common to a group of diseases caused by inflammation of tissue, cartilage and tendons. First of all, a person begins to experience pain in the knee area, which increases with increasing load on the legs. In order not to confuse the symptoms with the manifestation of other ailments, you need to know how the leg hurts when the anterior or posterior collateral ligament is damaged.

A person begins to feel discomfort when he needs to bend and straighten his leg at the knee.

Discomfort is associated with flexion and extension of the leg. Movements to straighten the lower leg become painful in the evening and in the first stage of the disease go away after resting for several hours. With the development of ligament degeneration, pain intensifies and is permanent. At the chronic stage, it is difficult to bend and straighten the knee, it is impossible to tuck the leg and touch the heel to the buttocks. The temperature does not rise. Redness and slight swelling may appear at the site of tendon inflammation.

If left untreated, the disease can lead to rupture of the patellar ligament.

How is diagnosis carried out?

The doctor determines the presence of the disease by examining the knee and palpating the medial and lateral ligaments. In cases where the diagnosis is in doubt, hardware diagnostic methods such as MRI and radiography are prescribed. Recommended to pass general analysis blood to detect inflammatory processes. Self-diagnosis is often erroneous and leads to worsening of the disease, so at the first suspicion of tendinitis, it is better to go to the hospital without delay.

Methods for treating tendinitis of the patellar tendon

At the beginning of the development of pathology, the patient can get by with taking medications.

Depending on the stage of the disease, a set of measures to neutralize it is selected. The operation is considered a last resort and is performed only when the disease becomes chronic, threatening the patient with disability. Treatment of cruciate ligament tendinitis with conservative methods is shown in initial stages and involves a combination of drug therapy with physiotherapy and gymnastics.

Conservative treatment

A set of traditional techniques will help treat the disease without the use of severe medications and is effective at the initial stage of tendinitis, when degenerative processes in the knee are reversible. Microtraumas of the cruciate ligament are eliminated by rest and wearing special supports - tape tapes and elastic bandages. Deep heating and tissue restoration are provided by ointments with comfrey and larkspur, and mineral mud. At an advanced stage, the doctor prescribes UHF and electrophoresis of the knee, magnetic therapy. If the disease is detected and at any stage except chronic, it is recommended to carry out the following methods of combating tendinitis:

• reducing the load on the knee joint, reducing the intensity of training;
• using dry ice packs to relieve pain and swelling;
• the use of anti-inflammatory ointments and tablets that help boost immunity;
• performing physical therapy exercises, yoga and Pilates;
• wearing supporting knee pads, bandages, and taping of ligaments.

Surgery

Surgery can be performed using arthroscopy.

Surgery to treat tendinitis is performed as traditional open method, and with the help of an arthroscope. Therapy consists of removing damaged tissue, mainly in the area of ​​the head of the patella. The doctor makes the choice of surgical intervention method depending on the area and nature of the degenerative processes in the ligaments. Osteophytes are removed arthroscopically, but if there is a cyst in the kneecap, only the traditional open surgical method is indicated.

After the operation, the patient must remain calm and undergo a rehabilitation course, including therapeutic exercises for knee development, physiotherapy and medicinal tendon rehabilitation. Regeneration takes from 1 to 3 months. At this time, it is necessary to provide the leg with additional support in the form of a knee brace or taping. You need to walk using a cane.

Other ways

Popular methods of treating tendinitis include sanatorium-resort treatment - mud therapy and balneology. Azov and Black Sea estuary muds, radon and hydrogen sulfide baths. At home, the use of laser-ion devices such as Vitafon is also common. Ointments and gels for athletes help to heal microtraumas, the purpose of which is to relieve muscle spasm and nourish the tissues of the joint capsule and tendons.

After injury, intense physical activity, or various diseases In the knee joint, the ligaments and tendons that attach the patella often become inflamed. This disease is called knee tendinitis. Tendons are most often affected where they attach to bones.

Features of knee tendinitis

The inflammation mainly affects the ligaments that help to straighten the leg. They are located at the bottom of the patella and are attached to the tibia. The disease develops due to microtrauma of the ligaments. Due to heavy physical activity, small tendon ruptures occur. If they do not have time to recover, they become inflamed.

There is acute tendinitis of the knee joint, which develops as a result of injury or infection of the ligaments. If there is salt deposits in the joint, a chronic form of the disease occurs. The disease may be accompanied by bursitis - inflammation of the joint, tendinosis - inflammation of the surrounding soft tissues. Due to the inflammatory process, the strength of the ligament decreases as the disease progresses, so with any careless movement it can tear.

Why does tendonitis develop?

The disease can affect a variety of people, regardless of age and gender. But most often, athletes who constantly expose the knee to increased physical activity suffer from inflammation. Therefore, the joint affected by tendonitis is also called “jumper’s knee.” But inflammation can also develop for other reasons:

• because of infectious diseases, fungal or helminth infections;
• due to rheumatoid arthritis, kidney disease or diabetes mellitus;
• due to salt deposits and gout;
• How allergic reaction for certain medications;
• due to poor posture, wearing uncomfortable shoes;
• degenerative changes in the joint that occur with age.

Pain first appears with increased physical activity

Symptoms of the disease

The main symptom of knee tendonitis is pain. In most cases, the disease goes through several stages. At first, pain appears only after heavy exertion, then after any work or even walking. It is especially noticeable when extending the leg: while climbing stairs or standing up. At the last stage, the pain becomes more severe and bothers the patient even at rest.

In addition to this symptom, the presence of the disease can be judged by other signs:

• there is a restriction in joint mobility;
• the knee is swollen, red, hot to the touch;
• painful sensations occur when touched;
• Creaking noises are heard when moving the knee joint.

Diagnostic methods

For appointment proper treatment It is important to accurately determine the cause of inflammation, the stage and nature of the disease. For this, in addition to an external examination, the doctor prescribes various examination methods:

• Ultrasound helps determine changes in the structure or length of the ligaments;
• CT and MRI identify cases where it is necessary surgery, if they started degenerative changes in bundles;
• X-rays can determine the presence of concomitant diseases: arthritis, arthrosis or gout;
• are still being appointed laboratory tests, which determine if inflammation occurs due to infection or autoimmune diseases.

It is necessary to distinguish the disease from arthritis, with which it has similar symptoms. But with arthritis, the pain is constant, diffuse. Tendinitis causes localized pain, mainly with movement.

Injections medicines help relieve pain and inflammation

Treatment of tendinitis

The modern level of development of medicine makes it possible to completely cure inflammation of the ligaments without serious consequences. But for this you need to consult a doctor in time and follow all his recommendations. Treatment of tendinitis in the first stages of its development can be achieved by the following methods:

• immobilization of the limb and reduction of the load on the joint;
• drug therapy;
• physical therapy;
• physiotherapeutic procedures;
• folk remedies.

Load reduction

In the acute stage of the inflammatory process and severe pain, immobilization of the knee is necessary for some time. To reduce the load on the patellar ligaments, taping, wearing special orthoses or plaster casting are used. This helps relieve pain and prevent ligament damage. In the initial stages of the disease, it is enough to limit running, jumping, not kneeling, and less often climbing stairs.

Physiotherapeutic techniques are often used in the treatment of tendonitis

Drug treatment

Medicines help relieve pain and reduce inflammation, but this is only an auxiliary treatment method. The most commonly prescribed non-steroidal anti-inflammatory drugs are: Ibuprofen, Naproxen, Piroxicam, Indomethacin. They can be used in the form of tablets, injections or ointments.

If after two weeks of therapy there is no improvement, more serious drugs are used - corticosteroids. In severe cases of the disease, the introduction of platelet-rich plasma can be used. This promotes faster regeneration of tendon tissue.

In case of infectious tendinitis, the use of antibacterial drugs.

Folk remedies

Such methods are used as adjuvant treatment. This can be ingestion of various decoctions or tinctures, compresses or applications to the joint area. After consulting with your doctor, you can use the following remedies:

• drink a decoction of bird cherry berries;
• alcohol infusion of partitions walnut;
• use curcumin and ginger regularly as food seasonings;
• make compresses with aloe juice;
• applications from fresh ginger infusion;
• Contrast procedures are useful: massage with ice cubes, and then warming the joint with a bag of salt.

It must be remembered that heating and compresses are done only if there is no redness or swelling of the joint, and it is not hot to the touch.

Special exercises are needed to restore ligament mobility

Special exercises that strengthen muscles and ligaments are effective. Most of them should be aimed at stretching the quadriceps muscle. Yoga classes under the guidance of an instructor and swimming are very effective. The following exercises are useful:

• muscle stretching;
• raising legs from a lying position;
• swing your legs with resistance;
• walking on a treadmill;
• squeezing the ball with your knees.

It is very important that the increase in intensity of exercise is gradual. A return to normal activities, especially for athletes, is possible only after the complete disappearance of pain and inflammation.

It is important to avoid heavy loads and give your knees rest when playing sports.

Physiotherapeutic treatment

Most often, massage is prescribed for knee tendinitis. It effectively relieves pain, helps heal and restore ligaments. In addition, the doctor may prescribe iontophoresis, UHF, magnetic therapy, electrophoresis, and paraffin baths. But warming procedures are contraindicated when rheumatoid arthritis, therefore they are used only after an accurate diagnosis of the causes of the disease.

Surgical intervention

It is necessary at the last stage of the disease, when a tear or complete rupture of the ligament has occurred. The operation also helps to remove cysts, eliminate vasoconstriction and other degenerative changes in the tissues of the knee. Tendon length correction is often performed to help restore quadriceps function. Rehabilitation after surgery is long, the patient can return to normal life in 3-4 months.

Preventing tendinitis

Treatment of ligament inflammation takes a long time, pain interferes with the normal course of life, and complications can lead to disability. Therefore, it is necessary to know how to prevent the development of tendinitis. To do this, you need to protect the knee joint from excessive and monotonous loads, and periodically give the muscles and ligaments rest when playing sports.

Those at risk for tendinitis include athletes, people who perform monotonous leg movements, or people who stay long time in one position. To prevent tendon inflammation, it is important to dose physical activity. If you experience knee pain, you should consult a doctor so that treatment can begin on time. Then after 1-2 months the functionality of the knee will be restored.