Tendons are fibrous bands of tissue that connect muscle to bone. When tendons become inflamed, irritated or suffer microscopic tears, the condition is called tendonitis. Patellar and quadriceps tendinitis are the most common in the knee. Occasionally, IT band tendonitis can cause pain on the outside (lateral) aspect of the knee.
The four quadriceps muscles meet just above the kneecap (patella) to form the quadriceps tendon. The quadriceps tendon attaches the quadriceps muscles to the patella. The patellar tendon attaches the bottom of the kneecap (patella) to the top of the shinbone (tibia). It is actually a ligament that connects to two different bones, the patella and the tibia. The quadriceps and patellar tendon work together to help straighten the knee. The iliotibial band (IT band) is a tough band of fibers that runs down the outside of the leg and attaches to the outside of the knee.
Tendonitis is often a result of repetitive movements like jumping or kneeling. This overuse leads to tiny tears, which cause pain and swelling. Activities that require repetitive jumping, kneeling, or running can lead to tendonitis. Although athletes who participate in sports that require these movements are at higher risk, any active person can develop knee tendonitis. The risk of developing tendonitis is higher if you suddenly increase your physical activity. Other risk factors include increased age, weight, and chronic diseases that may weaken the tendons.
Pain is the most common symptom of knee tendinitis. You may experience pain along the front of your knee. Initially this may be with physical activity. It can progress to include pain at rest. In IT band tendonitis, the pain is usually on the lateral side of the knee and may extend up the outside of the thigh. You may also notice swelling or stiffness in the knee joint.
The diagnosis of tendonitis is made through a thorough history and physical examination. Dr. Faucett may ask if you participate in any sporting activities that may put you at risk for developing tendonitis. They will check to see if you have any tenderness or swelling around the patella or on the outside of your knee. X Rays may be helpful in ruling out any bony abnormalities that may be causing your pain. Ultrasound or MRI may be used to evaluate the tendons or rule out a tear.
Fortunately most cases of tendinitis respond to conservative or non operative treatment and do not often require surgery. Conservative treatment options include:
- Rest, activity modification to avoid putting further stress on the tendon
- Anti inflammatory medication to help reduce pain and swelling
- Physical therapy is not only important for helping to reduce pain but to strengthen the muscles around the knee joint
- Other modalities such as using a patellar tendon strap or K taping may be helpful in managing symptoms
It can take several weeks to months for symptoms to resolve. If there is severe damage to a tendon, surgery may be required but this is not often the case.