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 or Tendinitis as this condition is also known as:

• 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.
  

Causes
Knee tendonitis is caused by overuse, injury or due to aging.

• 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.
  

Treatment for Knee Tendonitis

Modern medicine

• Orthopedic surgeons recommend conservative treatment for knee tendinitis. 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 tendinitis is rare. However if the person develops a tear in the tendon,surgery is the only answer.
  

Natural treatment for knee tendinitis

• 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.
  

Patella Fracture

A break in the kneecap is known as a fracture of the patella. A fall from a height, a direct blow to the knee and indirect stress are some of the frequent causes of patella fractures. Severe pain, swelling, tenderness and difficulty in straightening the knee are some of the common symptoms associated with patella fracture. Fracture of the patella is also known as kneecap fracture, broken knee, knee fracture and broken patella.

Causes of a Patella Fracture

• Direct force on the patella can result in fracturing the patella.
  
• A fall from a height or a hit to the knee which is very common in contact sports.
  
• During an automobile accident, when a knee that is bent hits against the dashboard and can lead to a patella fracture.
  
• Indirect stress is one reason that can cause patella fracture.
  
• Twisting of the leg.
  
• Muscle contraction that is violent.
  
• Calcium deficiency due to poor nutrition.
  
• Persons who are obese are more prone to this kind of fracture if they suffer a fall.
  
• Joint diseases such as osteoporosis or bone diseases increase the risk of fracture of this kind.

Severe pain and swelling at the area of the fracture is noticed when a person fractures his patella. It will be difficult to move the leg either forward or backward or extend it. There may be swelling and tenderness around the kneecap along with catching or locking of the knee. If bone fragments split enough to bend or twist normal knee contours, deformity of the knee will be apparent. The patient may experience numbness and chill that extends beyond the site of the fracture, if the blood supply at the site gets affected. In a compound fracture or open fracture, the skin is broken by the bone in extreme cases. Immediate attention should be given to this open fracture to avoid infection. The fracture of the patella is classified into three different types.

• As a result of a direct blow an undisplaced fracture of the patella may occur
  
• A direct blow to the front of the knee or a fall can cause a stellate or comminuted fracture. Compromised anterior skin and subcutaneous tissue may be associated with this type of fracture which may be the result of a direct trauma.
  
• The third type is a transverse fracture where there is a gap between the fragments. There is possibility for this fracture when there is a forced, passive flexion of the knee joint is associated with a contraction of the knee joint extenders or the quadriceps muscles.
  

There should not be any delay in realigning the broken bones to reduce the shock. To determine if the patient has suffered a fracture the physician will request for x-rays and stress films after he examines the knee. To immobilize the fracture site, the physician may realign the broken bones and place the knee in a cast or splint only if the fragments of bones are lined up well. Surgery is the other option to remove broken pieces of the knee. A person who has suffered a patella fracture is more prone to knee problems in the future.

Iliotibial Band Syndrome

Iliotibial Band Syndrome or 'Ilitibial Band Friction Syndrome' is a common sports injury generally associated with running. This syndrome is bound to cause lateral knee pain in runners. This injury can also be caused by biking, hiking and weight lifting. This Iliotibial band is a thick fibrous tissue that runs from the outside of the pelvis, over the hip, knee and below the knee joint. The band stabilizes the knee during movements like running. The band coordinates with several other thigh muscles and moves from behind the femur in the thigh to the front during the gait cycle. The Iliotibial Band Syndrome refers to the superficial thickening of the tissue that is on the outside of the thigh. Continuous rubbing and flexing of the band causes irritation usually over the outside of the knee joint.

Common causes of the Iliotibial Band Syndrome among runners

• Iliotibial Band Syndrome occurs when the level of activity increases especially among runners who tend to increase their mileage. Increasing distance too quickly or excessive downhill running is a common cause among runners.
  
• Poor training habits in runners can cause this syndrome. While running on an indoor track, the leg bends slightly inwards and this causes extreme stretching of the Iliotibial band and the resultant injury.
  
• Inadequate warm up and cool down sessions among sports persons can cause this syndrome.
  
• While cycling, having the feet 'toed in' at an extreme and excessive angle can cause the Iliotibial band injury.

Individuals with anatomical abnormalities of the leg such as bow legs, high or low arches, overpronation of the foot and uneven leg length are prone to this condition. Muscle imbalance such as weak hip abductor muscles can lead to iliotibial band syndrome.

Symptoms of this syndrome include pain in the knee joint that worsens with continued movement and resolves on rest. There is persistent pain below the knees or stinging sensation just above the knee joint. Often swelling or thickening is noticed at the point of knee joint where the band moves over the femur. Persons suffering these symptoms must avoid running downhill or squatting, playing tennis or basketball and indulging in martial arts.

Treatment for Iliotibial Band Syndrome normally begins with applying ice the area of injury, selection of proper footwear and stretching routine. While icing, the injured part has to be kept elevated as this helps to reduce swelling. Anti-inflammatory medications and cortisone injections may be prescribed to reduce the inflammation. Surgery is rarely resorted to.