What is a Knee Tendinopathy?
Tendinopathy is characterised by pain and stiffness in a tendon that worsens with activity. It is most often a result of micro tears along the length of the tendon caused by repetitive strain. The type of tendon damage broadly falls under either
Tendinosis
or
Tendonitis
, which affects what kind of treatment will yield the best results.
Knee Tendinopathy is an injury in the form of swelling and micro tears typically to either the Infra-Patellar tendon that connects the patellar to head of the Tibia, or the Supra-Patella tendon that connects to the quadriceps muscle. Although any tendon in the knee can be affected, which include the Semitendinosus tendon, Gracillis tendon, Sartorius tendon, Iliotibial band and Hamstring tendon.
What causes Knee Tendinopathy?
Tendinopathy is an umbrella term for damage caused to a tendon and is broadly divided into two common types, Tendinosis or Tendonitis. Tendinosis is the degeneration of collagen fibres that make up the tendon. As a result of chronic over loading and repetitive strain on the tendon, its type 1 collagen fibres are replaced with weaker, immature type 3 collagen fibres. The resulting micro tears that occur as a result of this weakness cause a cycle of repair that thickens the tendon. It is this thickening that eventually causes interference with the surrounding tissues, triggering inflammatory responses and the associated tendonitis.
Inflammation is the key difference in symptoms for Tendonitis. The inflammation can have a variety of causes other than the tendon thickening common to Tendinosis. These include direct injury from an impact to the tendon, creating a tear, or infection from an open wound near the site of the tendon. However, the most common cause is micro tears from overuse, typically from running, sports or active jobs.
Above: Treatment for ankle tendinopathyKnee Tendinopathy is a result of this same process that starts with the overloading and repetitive strain of the tendons in the knee. Although anyone can develop a Knee tendinopathy, it is most commonly seen in individuals engaged in sports involving running and jumping. Contributing factors include;
- Inappropriate footwear
- Hard or uneven training surfaces
- Sudden increase in training activity
- Poor posture or running technique, causing biomechanical abnormalities .
Risk of Tendinopathy will increase as you age, due to the natural deterioration of the tendons. You will lose flexibility in the surrounding structures and the tendon itself, increasing the frequency of micro tears during activity.
What are the symptoms of Knee Tendinopathy?
Symptoms of Tendinopathy will vary slightly depending whether you are presenting with Tendinosis or Tendonitis. Although many of the symptoms as similar, which can lead to one being mistaken for the other. Symptoms include;
Tendinosis :
- Stiffness, usually worse in the mornings.
- Tenderness along the length of the tendon.
- Grating, rubbing or catching sensation in the tendon when in use.
- Symptoms worsen with prolonged activity, especially with sports.
Tendonitis :
- Symptoms include those listed above for Tendinosis, but also the following;
- Tendon area is warmer to touch then surrounding skin.
- A palpable lump along the tendon is sometimes detected.
How is Knee Tendinopathy Diagnosed?
To diagnose a Knee Tendinopathy, a full assessment is required. At Liverpool Physio, our physiotherapists can provide a detailed assessment to ensure you are given the correct diagnosis and treatment for your injury.
For more information on how Physiotherapy can help treat Tendinopathy, or to book yourself an appointment, please contact us via email at office@liverpoolphysio.co.uk or ring us on 0151 558 0077
What would a physiotherapy assessment for Knee Tendinopathy involve?
If you book in with us at Liverpool Physio, our Physiotherapists will seek a comprehensive amount of information about your injury to make sure you receive the correct treatment. Your first appointment would include an assessment which is split into two parts.
Subjective
A conversation between our physiotherapist and yourself, to discover what may have caused the onset of your symptoms and gain an understanding of the impact these symptoms have had on your lifestyle.
Objective
Taking into consideration your current pain, this part of the assessment would look at your available movement, ability to walk, balance, stand on your toes and carry out functional tasks, and special tests to identify if there is a Tendinopathy.
What would physiotherapy treatment for Knee Tendinopathy involve?
If you have a knee Tendinopathy, you will have the best outcome if you start your treatment as soon as possible to prevent more damage to the tendon.
Our experienced physiotherapists will provide you personalised treatment sessions for your injury to reduce your pain and swelling around your foot and calf and progress to improving your muscle strength and flexibility. Your treatment sessions are likely to include;
- Ice treatments
- Heat treatments
- Stretching
- Joint mobilisations
- Ultrasound to encourage healing
- Soft Tissue Massage
- Advice and education on how to change your activity whilst your Tendinopathy is healing
- Activity specific exercises (tailored to your lifestyle or sport)
- Strengthening exercises, targeted for Tendinosis presentations.
- Biomechanical and gait analysis.
How can I arrange a physiotherapy assessment for Knee Tendinopathy?
If you are having problems including pain, stiffness or signs of inflammation around one of your joints you may have a Tendinopathy, and would benefit from an assessment at Liverpool Physio from one of our experiences physiotherapists.
You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, or give you details on self-management for minor cases. To arrange an appointment please email office@liverpoolphysio.co.uk or call 0151 558 0077 .
Summary
A Tendinopathy can be very painful and have a pronouncedly limiting effect on you daily activities and sports participation. Without early treatment the condition can easily become chronic and take far longer to heal. With Physiotherapy intervention we can reduce your painful symptoms and speed up recovery.
Our specialist physiotherapists at Liverpool Physio can identify which type of tendinopathy you have a tailor a treatment plan to your specific needs. We can use a combination of massage, mobilisations, stretching and strengthening exercises to ensure you achieve the best possible return to normal function. Every treatment session will aim at getting you back to the normal daily activities and sports you enjoy.
For more information on how Physiotherapy can help treat Tendinopathy, or to book yourself an appointment, please contact us via email at office@liverpoolphysio.co.uk or ring us on 0151 558 0077
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