→ a strain or tear in the knee’s connecting tissues.
The knee is a connecting point for various strong, fibrous cords that we call muscles, tendons and ligaments. While ligaments (like the ACL and PCL) connect one bone to another, tendons connect muscles to bones. In the knee, the quadriceps tendon joins the thigh to the kneecap (patella) while the patellar tendon joins the kneecap to the tibia (shinbone). Any of these muscles and tendons can be injured.
One common way of injuring knee muscles and tendons is through overstretching, where the fibres become strained or torn. Another common cause is a powerful impact – such as a blow to the front of the knee, a heavy fall, or even a deep cut during an accident. The fibres can become overstretched, or they may tear – either partially, or completely (a rupture). Tendinitis is a condition where the tendon becomes inflamed, usually due to overuse (which is why it is commonly seen in runners). As well as pain and swelling, it can cause the tendon to become weaker, which in turn makes it more vulnerable to injury. Tendinosis (also known as chronic tendinitis) is a condition where the tendon degenerates or becomes scarred due to a repetitive injury. Osgood Schlatters is a condition where tightened thigh muscles pull on the bone below the knee (the tibial tubercle), causing it to become inflamed and painful. It is most commonly seen in adolescents, particularly after a growth spurt.
Symptoms vary depending on the cause of the injury, but the most obvious one is pain, particularly during movement. This might be accompanied by swelling, bruising or muscle cramping. Severe tears may have a visible deformity, such as an indentation on the knee, or a displaced kneecap where the patellar tendon has torn below it. Depending on the injury, it may be difficult to bend or stretch the knee. Tendinitis can be accompanied by swelling and redness, difficulty in moving the knee, and pain that usually worsens during movement. Osgood Schlatters tends to be accompanied by pain and swelling below the knee during and after exercise.
Diagnosing a knee muscle or tendon injury starts with a physical examination and a discussion with your doctor about how the injury first came about. X-rays can help to identify damage to the bone. MRI or ultrasound scans can give a better picture of damage to the tissue, or may be used to rule out other injuries with similar symptoms.
Milder muscle strains and tendon inflammation often heal naturally with rest, sometimes helped by applying ice or taking an anti-inflammatory like ibuprofen to reduce swelling. Braces and crutches can give the tissues further protection while they heal. Physiotherapy and an exercise plan may also help to strengthen the knee and legs. More serious tears – particularly ruptures – may require surgery in order to reattach damaged tendon to the bone. Once the disorder has been diagnosed, we will be able to explore the full range of options available to you.