We learn to recognize, prevent and correctly deal with a knee tendinopathy caused by running. Physiotherapist Dario Domeniconi talks about it
The term tendinite it is used, and often abused, to indicate an inflammatory state of the tendon. It has been found by various scientific studies that inflammation of the tendon, among other things very little vascularized, is very rare. Rather, the surrounding structures become inflamed with symptoms of pain, swelling and disability.
The specific degeneration of tendon fibers is called instead tI have a nose. This, on the other hand, may not manifest painful symptoms, having as its cause the aging of the tissues or excessive and repetitive wear of the fibers.
The tendinopathy it is therefore the term that collects the various diseases that a tendon can present. Including tendonitis and tendinosis. The most frequent tendinopathies in runners, whose pain map we have already seen in the first article, they are:
–Quadriceps tendinosis
Characterized by pain, including on palpation, over the patella, centrally or medially. It gets worse during jumps, runs or squats and the knee is sore and stiff even at the end of the activity and in the morning upon waking.
–Jumper’s knee, tendonitis or patellar tendinosis
It is an inflammation of the tendon fibers that cover the patella due to overload microlesions. Pain, under the patella, worsens during knee flexion especially in weight bearing and can be complicated by joint stiffness and quadriceps weakness.
–Popliteal tendinosis
It is characteristic in runners who cover many kilometers. The popliteal muscle has its posterior seat in the knee and allows its extension to be completed. Characteristically, his tendinosis causes a postural attitude with bent knees; full extension would result in greater tension on the tendon and therefore greater pain. It manifests itself as a sharp pain, during or after a run, on the outside of the knee; also typical of other runner pathologies (bandelletta syndrome e meniscopation).
–Tendinopathy of the ischium musclescrurali
The hamstrings are three muscles that originate from the pelvis and enter, or pass through their tendons, posterior to the knee. They are responsible for flexing the femur posteriorly by projecting the body forward. They are fundamental motors in running and often their tendons are injured causing immediate pain behind the knee.
Per to prevent tendinopathies we recommend:
° carry out an adequate pre-run warm-up.
° avoid overloads of distance, speed, type of surface, height difference.
° avoid repetitive and incorrect postures and movements.
° train the correct execution of the athletic gesture.
° respect the recovery times, different for age and type of race.
° avoid overweight.
The teacher Jill Cook, LaTrobe University of Melbourne and one of the leading experts in tendinopathies in the world, helps us to set up a correct rehabilitation approach:
The absolute rest reduces the tendon’s ability to withstand loads, thus worsening the existing pathology. Carry out weight-bearing exercises always remaining below the pain threshold.
Passive treatments like ice or electrotherapy may reduce pain in the short term, but they are totally ineffective in the long run.
Pain non it must be scary, but it must be used in exercises as a signal to understand how much the tendon can be loaded. Pain helps us understand how recalibrate the loads that the tendon can withstand. One of the biggest mistakes runners make is running covered in anti-inflammatories and painkillers and inhibiting this all-important feedback.
Passive stretching increases the compressive forces on the tendon making it worse the symptomatology. Massaging the tendon directly can provide momentary relief only to get worse again in a short time. Absolutely avoid using foam rollers directly on the tendon. The massage it can instead be useful on the musculature that attaches to the suffering tendon.
Spending little time on rehabilitation doesn’t work. Passive therapies (ultrasound, tecar, tens) can bring in the best of cases only a benefit short term. When the tendon is subjected to an important load the pain will recur. A good rehabilitation of a tendon, lasting 3 months, leads to excellent results in the long term.
Jumps, changes of direction, sprints are activities to be avoided in the first period and to be managed with a progressive increase later on. Strength exercises they can help a lot to heal a tendon.
NB For the complex and variable pathological definition of a tendon pain in the knee, we recommend the opinion of a specialist who can confirm the diagnosis.
Ft. Dario Domeniconi, Fisiorunning.net
PREVIOUS EPISODES:
BANDELLETTA, A WORD THAT MAKES RUNNERS SHAKEN
DO YOU RUN AND YOUR KNEE HURT? MAYBE YOU HAVE PFP SYNDROME
RUNNER, EYE TO KNEE: TELL ME WHERE YOU HURT AND I WILL TELL YOU WHY
HOW TO START RUNNING AFTER THE OPERATION AT MENISCO
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13 November 2020 (change 13 November 2020 | 08:21)
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