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.
  

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.

A bursa is located between the bones and tendons of a joint. Bursitis is a condition where any of the bursa in the body gets inflamed. This leads to inflammation and pain. In most cases, bursitis affects elbows, hips and shoulders. Some persons face bursitis in the knee or heel. Bursitis can occur due to injury, gout, arthritis or any rheumatic condition. In rare cases, bursitis can be traced to a staphylococcal infection. Repeated physical activity or trauma can bring on an attack of bursitis. Activities such as gardening, shoveling, tennis, golf and skiing can lead to development of bursitis.

Symptoms of bursitis include dull ache and stiffening of the affected joint and pain on movement. There may be redness on the skin around the inflamed bursa. X-rays indicate any calcification in the location. The affected area becomes tender and wollen. Any movement becomes painful and troublesome. Rest and immobilization of affected area usually gives relief from bursitis. Heat application often gives relief. Physical therapy and exercise also aid in relieving discomfort and pain associated with bursitis. NSAIDs can help in reducing inflammation. Corticosteroids may be prescribed for severe pain. Aspiration can be done at the location of the swelling to reduce inflamation. In rare cases, surgery is performed to remove the damaged bursa.

Bibliography / Reference

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