You often notice it the first time you get out of bed or while climbing stairs: a nagging, sometimes sharp pain around your knee. Knee tendinitis, also known as tendinitis in the medical world, is a common complaint that can hinder you considerably in your daily life and during sports. Whether you are an avid runner or just enjoy walking, this injury requires the right approach. At Fysio Fitaal, we will help you identify the cause and restore your knee's load-bearing capabilities so that you come back stronger.
The muscles in your thigh and lower leg are attached to the bones of your knee joint by tendons. These tendons ensure that your knee is stable and can move. In tendinitis, the protective layer of the tendon has become damaged, often due to overuse. In response, the tendon inflames, causing pain, heat and swelling. It is important to know that there are several tendons running around the knee that can become inflamed.
The exact location of the pain often tells us which tendon is affected. The most common variant is inflammation of the patellar tendon. This is the tendon that runs from your kneecap to your shinbone and is an offshoot of the major thigh muscles. Pain at the front of the knee, just below the kneecap, often indicates this ‘Springer's Knee’ or Jumpers knee.
Are you experiencing pain at the side (outside) of your knee? If so, you may have iliotibial band syndrome, also known as Runner's knee or Runners knee. Also on the inside of the knee, tendons can become irritated (such as the pes anserinus), which is often accompanied by nagging pain when bending the knee.
Tendonitis is characterised by a distinct pattern. You often feel pressure pain right at the site of the affected tendon. The skin around the tendon may feel warm and there may be swelling, making the knee less mobile. Typical of tendon complaints is starting pain and stiffness: the first movements are painful, but as soon as you warm up, the pain seems to subside for a while.
The course of symptoms often goes through three phases. In the first phase, you only feel pain after the exertion. In phase two, the pain is also during present during exercise, although it may decrease temporarily after a warm-up. In the third stage, the pain is chronic and you feel it even at rest and during simple daily activities.
The main cause of tendonitis is long-term overuse. We see this a lot in sports with explosive movements or a lot of jumping, such as football, volleyball, basketball and athletics. Here, the tendon is loaded more often or more heavily than it can handle at the time.
Besides sports strain, other factors also play a role. An incorrect leg position, such as O-legs or X-legs, can cause uneven pressure on the tendons. Being overweight, incorrect running technique or poor footwear are also risk factors that increase the likelihood of inflammation.
To start the right treatment, a proper diagnosis is essential. We can often determine whether it is tendonitis based on physical examination. At Fysio Fitaal, however, we go a step further. We use ultrasound to look inside the knee. This allows us to assess the quality of the tendon: is there active inflammation (with lots of fluid), or is the tendon structure itself affected (tendinosis)? This distinction is crucial in determining the right treatment plan.
In the first phase of tendinitis, relative rest is often enough. That doesn't mean you shouldn't do anything, but you should temporarily reduce peak loads (such as jumping or running). Cooling can help to dampen the sharp pain.
When symptoms persist, physiotherapy is necessary. Our treatment first focuses on pain reduction, for example through taping or shockwave. However, the core of rehabilitation is exercise therapy. Rest alone will not solve the problem in the long term; the tendon must become stronger again. We increase the load capacity of the tendon step by step with specific exercises. Sometimes a brace can provide temporary support to reduce pressure on the tendon during daily activities.
Recovery from tendinitis requires patience. Depending on the severity and how long you have been walking around with the complaint, recovery takes six to 12 weeks on average. For chronic complaints (stage 3), this process may take longer.
Don't stick around with sore tendons in your knee. The sooner you start the right treatment, the sooner you can move pain-free again. At Fysio Fitaal, we are ready to help you with a diagnosis (possibly with ultrasound) and a personalised treatment plan.
You recognise it by pain, warmth and swelling specifically on the tendon (under the kneecap, on the side or inside). You often experience starting pain that subsides after a warm-up, but returns after exertion.
In the initial phase, it is important to take rest from provocative activities and cool down if necessary. If the symptoms do not disappear within a few weeks, physiotherapy with targeted exercise therapy is the best solution.
In phase 1 (pain only after exercising), you can often continue exercising, provided you adjust the intensity. In stages 2 and 3, where pain is present during exercise, we recommend temporarily stopping the load to prevent further damage.
In acute inflammation that is warm to the touch and swollen, cooling often has an analgesic effect. Heat is usually not recommended in active inflammation, as it may worsen swelling.
A knee brace can certainly help. It provides extra stability and reduces pressure on the affected tendon, which can aid recovery and reduce pain.
Patellafemoral pain syndrome is an umbrella term for several complaints at the front of the knee
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