Tendons are connective tissues in the body that connect muscles to bones, aiding the body to move when the muscles contract. Tendon injuries typically arise due to overuse of the muscle involved. Tendon injuries can range from acute tears to chronic injuries characterised by microtears and degeneration, a condition known as tendinosis. The term used to describe any abnormality in the tendon is tendinopathy.
The tendon injuries can occur in different locations on the knee. These tendons can be grouped into tendons that are at the front of the knee, and tendons that are located at the back of the knee.
At the front of the knee, tendinopathy can arise at the patella tendon, which connects the knee cap to the shin bone. This form of tendinopathy is commonly referred to as “jumper’s” knee. It commonly arises from overuse of running and jumping.
Tendinopathy can also arise from the insertion of the quadriceps muscle onto the knee cap, a condition known as quadriceps tendinopathy. It is commonly injured in the same way the patella tendon is injured, from overuse during running and jumping.
Also at the front of the knee, at the inner side of the shin bone, is the insertion of the hamstring tendons, which are a group of often injured tendons that help with knee bending. Tendinopathy of these tendons are an uncommon cause of knee pain in this area.
At the back of the knee, lies the insertion of the biceps femoris and popliteus tendons, tendinopathy of which will result in pain.
Your doctor will first discuss your symptoms and the possible cause of your pain with you. He/she will then conduct a focused examination based on the information gained. This examination will include palpation of the involved tendon regions, to elicit pain.
Based on the findings, scans such as ultrasound and MRI scans may be ordered to confirm the diagnosis. These scans will also provide information about the severity of the injury.
There are non-surgical and surgical methods to treat tendon injuries, depending on severity of the injury, the chronicity, and response to other types of treatment.
Medications to treat pain and inflammation can be helpful to reduce the pain and swelling caused by tendon injuries. The mainstay of such treatment are non-steroidal anti-inflammatory drugs (NSAIDs).
Rehabilitation and physiotherapy is an important part of the treatment for tendon injuries. Stretching and other exercises/modalities may be introduced to help with tendon recovery. Evidence has shown that some amount of tension placed on injured tendons aids recovery.
Shockwave therapy involves the use of external shockwaves generated by a special machine. These shockwaves can stimulate healing and aid in tendon recovery. Several treatments are usually necessary.
Steroid and local anaesthetic injections are indicated in certain tendon injuries around the knee. These injections reduce inflammation and pain and allow for more effective rehabilitation.</>
Platelet rich plasma injections are healing factors extracted from your blood, which is then injected in higher concentrations into the region around the tendon. This aids tendon healing.
In some patients, tendon injuries may be too severe for non-surgical treatment. In others, non-surgical methods may have been tried but may have failed to resolve tendon injuries. In that case, surgery is an important option to consider.
Surgery for tendon injuries around the knee may include,
For an assessment of your condition, please book an appointment with Dr. Yong Ren.