Knee Tendonitis

Tendonitis is one of the most common injuries that affect the knee. In simple terms it means inflammation and/ or rupture of the tendons of the knee. Knee tendonitis is also called 'Jumper's knee' as it was first described in the takeoff leg of high jumpers. It occurs in dancers, runners and players and anyone who runs and jumps regularly suffer from it. Typical symptoms of knee tendonitis:

• Knee tendonitis produces pain, tenderness and stiffness near/on the knee joints.
  
• Worst pain is experienced when ascending or descending stairs or when getting up from a seated position.
  
• Chronic pain is common due tendon and ligament weakness and cartilage deterioration.
  
• Inflammation of the tendons in the knee occurs. The inflamed tendons are painful when moved or touched.
  
• The tendon sheaths are visibly swollen. This may be due to accumulation of fluid and inflammation.
  

• A small tear or inflammation in the knee caused the pain in knee tendonitis.
  
• Inflammatory diseases such as rheumatoid arthritis can also cause knee tendonitis.
  
• Popliteus tendonitis is caused by excessive inward rolling of the feet. This is called 'pronation'. This occurs when excessive stress is put on the tendon, thereby causing a tear or inflammation in the tendon.
  
• Pes anserine tendonitis is characterized by inflammation of the medial knee. This often coexists with other knee disorders.
  
• Semi membranous tendonitis is characterized by posteromedical aspects of the knee and tenderness. Here resisted flexion and 'outward turned strain' occurs.
  

• Orthopedic surgeons recommend conservative treatment for knee tendonitis. Physical therapy and injections are commonly administered.
  
• Modern treatment regime includes rest, cryotherapy, non-steroidal anti-inflammatory drugs, physical therapy and massage.
  
• For the athlete who wants to improve his/her condition much faster, cortisone injections are given every one to two weeks.
  
• Surgery for knee tendonitis is rare. However if the person develops a tear in the tendon,surgery is the only answer.
  

• Prolotherapy: In knee tendonitis that occurs in sports persons, the athlete is encouraged to perform exercises during the healing process. This natural medical treatment helps to strengthen structural weaknesses in the.
  
• The MEAT treatment consists of tendon and strengthening of ligaments by movement, exercise, analgesics and treatment by herbal supplies. The approach here is to encourage the damaged tissues to heal as quickly as possible without decreasing the inflammation quickly with ice or anti inflammatory drugs.
  
• A heat pad could be applied on the pain area for 15 -20 minutes to relieve pain.
  
• Similarly cold therapy can also be resorted to.
  
• Bracing is considered by sports persons to provide stability to the knee and thereby relieve pain by stimulating the nerve fibers which makes the wearer feels that the joint is more stable and secure. Football players, racers and skiers particularly benefit from such bracing.
  
• Avoid activity that can cause pain.
  

Crohn's Disease

Crohn's Disease is an intestinal disorder characterized by inflammation of the digestive tract. Crohn's disease is characterized by ulceration of the intestines and affects the GI tract. The exact cause for Crohn's disease is unknown thought it is suspected to be due to bacterial infection. Crohn’s disease is an inflammatory bowel disease that differs from ulcerative colitis in that the inflammation and ulceration is noticed in all the layers of the intestines. It is noticed that people of Jewish descent are at increased risk for developing Crohn's disease. The symptoms are similar to irritable bowel syndrome.

20% cases of Crohn's disease are heriditary in nature. Symptoms of Crohn's disease are rectal bleeing and diarrhea. There is abdominal pain and weight loss. Nutritional deficiencies are noticed with patients suffering from Crohn's disease caused due to poor absorption. There may be arthritis, skin problems or gallstones.

Blood tests are done to check for presence of certain antibodies that may help diagnose Crohn's disease. A colonoscopy can aid the doctor in examining the lining of the intestines and checking the extent of inflammation. A small sample may also be taken for biopsy. CT scans and small bowel x-rays can help in identifying the areas of inflammation within the intestines. Anti-inflammatory drugs are prescribed to control inflammation. Corticosteroids such as Prednisone are used in treating Crohn's disease. Antibiotics are used to treat bacterial overgrowth in the small intestine. Surgery is often resorted to in most cases of Crohn's disease. A part of the intestine is removed or any blockage is removed. But Crohn's disease is likely to resurface after some years of surgery.

Tennis Elbow

When there is inflammation of the tendons on the outside of the elbow at the lateral epicondyle of the upper arm, the condition is known as tennis elbow. This condition is caused by certain repetitive movements of the wrist Tennis players are not the only people who are affected by this condition, which is also known as lateral epicondylitis. Activities like hedge clipping, tennis, excessive use of a screwdriver or hammer, painting or any such activity that involves repetitive motion of the wrist which also requires constant gripping may lead to tennis elbow. Though, the real cause of tennis elbow is not clearly defined, it is due to tears of the tendons that attach the forearm muscles to the bone of the arm at the elbow joint.

Symptoms of tennis elbow

• Pain over the outside (lateral) of the elbow
  
• Pain while lifting or carrying objects or gripping even light objects such as a coffee cup.
  
• Pain radiates down the forearm.
  
• Tenderness is felt on or below the joint's bony prominence.
  
• Pain due to tennis elbow may last for about 6 to 12 weeks.
  
• The discomfort may be for a short duration or it may last for several years.

Normally the pain due to tennis elbow sets in gradually, though at times it may also occur suddenly. Most patients complain of pain in the dominant arm. Manual workers like painters, plumbers, carpenters and gardeners who use their hands face the risk of developing this symptom. Many sports participants like racquet sports players, golfers, fencers are also prone to tennis elbow syndrome.

Tennis elbow is not simply caused by inflammation of the tendons alone, consider experts. The degenerative process either due to aging, or repetitive use of the forearm may also be responsible. If there is poor blood flow in that area, it does not heal completely and accessing nutrition and oxygen necessary for healing becomes difficult. This condition will lead to small tears in the tendon because of its degeneration and is revealed as symptoms of tennis elbow.

X-rays help to diagnose tennis elbow for patients who have the usual symptoms near their forearm. If the doctor has any confusion, an EMG is sometimes obtained to confirm the diagnosis of a tennis elbow. Pain over the outside of the elbow may sometimes occur due to instability of the joint, elbow arthritis and radial tunnel syndrome. Though the symptoms of these conditions are normally distinct, they can be confusing at times.

Even after the initial injury is healed, these areas tend to tear again. Hemorrhaging will result because of this condition and there will be formation of rough, granulated tissue and calcium deposits within the surrounding tissues. Inflammation is caused due to leakage of collagen. The blood flow in this area is cut off because of the pressure developed due to inflammation. It can also squeeze the radial nerve that controls muscle in the arm and hand.

Bibliography / Reference

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