Knee Tendon Injuries: Causes, Symptoms, and Treatment Options

Injuries to the tendons surrounding the knee can occur, which can range from mild inflammation to a ruptured or torn tendon. Knee tendon injuries are one of the most common problems of the knee, which can occur at any age.

The Knee Joint

A joint is the point where two or more bones are connected. The knee is a large joint where the femur-the large bone of the thigh-meets the bone of the leg called tibia (shin bone). The patella (kneecap) is a triangular shaped bone in front of the knee joint, which slides when the knee moves and functions to protect the knee and gives leverage to muscles. The knee joint works like a hinge where it allows two major movements: bending and straightening.

Although a large joint, the knee needs surrounding and accessory structures such as tendons, ligaments, and muscles to become stable and be able to support the weight of the upper body. The knee joints should be flexible, strong, and stable for a person to be able to stand and perform movements such as walking, running, jumping, and turning.

Muscles are connected to bones through cords of tough tissue called tendons. The tendon connecting the quadriceps-muscles of the front thigh-to the patella is called the quadriceps tendon. This tendon will continue further down to attach to the shin bone as the patellar tendon. Maintaining strong muscles is important because it can help support and protect joints.

Equally important are the cartilages and ligaments. Cartilages in ends of bones in a joint are called articular cartilages. These tough materials act as shock absorbers, as well as provide smooth movement of the joint. The ligaments are tough cords that connect a bone to another bone. They also help provide stability to the knee joint.

Injuries Related to the Knee Tendons

The two most common tendon injuries are tendinitis and ruptured tendon. These conditions can occur as a result of overusing the tendon or sudden and forceful movement.

People who perform activities such as cycling, running, or dancing tend to overuse the tendon causing it to become stretched and inflamed. A condition called tendinitis. Sudden and forceful movement of the knees such as that occurs in heavy weight lifting, sprint running, or forceful jumping in basketball may cause torn or ruptured tendon.

Signs and Symptoms

Signs and symptoms of knee tendon injuries may include redness, pain or tenderness, and swelling on the joint. In addition, people with knee tendon injuries tend to have difficulty in bending, straightening, and lifting their leg. Some people may see that their thigh on the injured limb is uneven compared to the uninjured limb.

Diagnosis of Knee Tendon Injury

To diagnose knee tendon injury, the doctor will likely ask about your activities that may have lead to the injury. He or she will also perform a physical examination to feel for a defect in the tendon near the tear. To detect quadriceps tendon tear or patellar tendon tear, your doctor may recommend x ray of the joint. If images reveal that the patella is lower than normal, it may indicate quadriceps tendon tear. A higher than normal patella, may mean that the patellar tendon is torn. To confirm a partial or total tear, your doctor may recommend a magnetic resonance imaging (MRI) of the joint.

Treatment Options

Initial treatment of mild knee tendon injuries may involve PRICEM therapy. PRICEM stands for Protect, Rest, Ice application, Compression, and Elevation. Protect the knee from further injury. Rest and do not attempt to bend and straighten the injured knee. Applying ice helps in controlling inflammation and relieving pain. Make sure not to apply ice directly over the skin. Wrap the ice pack with towel first before applying to the injured area. Avoid applying hot pack or hot compress during the initial injury because this can aggravate the swelling. Elevate the limb to help control inflammation. Taking nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen can also help relieve pain. Applying elastic bandage may also help compress the injured area and reduce swelling. However, applying elastic bandage should be done by a trained person as improper application may impede blood flow causing damage to tissues.

A torn tendon requires a different treatment approach and takes a longer time to heal. The reason why tendons heal at a slower rate is because they have little blood supply.

A complete tear in the tendon requires surgery to reattach the ends and application of cast to immobilize the joint. The cast is worn for about 3 to 6 weeks. Bearing weight on the affected limb should be avoided during the first few weeks to allow healing. Your physical therapist or health care provider will tell you when you can perform weight bearing on the affected limb. Your physical therapist will also teach you how to use crutches to aid you in walking.

Surgery may not be necessary in partially torn tendon. However, application of cast may be needed to restrict movement of the involved joint and to allow healing of the tendon.

Your doctor or physical therapist will formulate an exercise program to rehabilitate the involved knee. The aims of rehabilitation are to restore normal flexibility of the joint, strengthen the muscles, and patient education to prevent repeat injury. Also, it aims to maintain normal strength of the upper limbs and uninjured limb. A rehabilitation program may last for about 4 to 6 months depending on the extent of the injury. However, many people can resume many normal activities before then.

References:

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Q&A About Knee Problems. National Institutes of Health.NIH Publication No. 06-4912

Tortora, G. and Grabowski, S.: PRINCIPLES OF ANATOMY AND PHYSIOLOGY. 10^th ed. John Wiley and Sons, Inc., 2003.

Seeley, R., Stephens, T., and Tate, P.: Essentials of Anatomy and Physiology.5^th ed.Mc-Graw-Hills, Inc., 2005