Overuse problems of the knee :

tendonosis or tendonitis? - - Posted by ret13 (ret13), 24 February 2004

I have had problems with my knee for well over 2 years now.  I am 25 and have always enjoyed sports, particularly football.  When I first noticed occasional, sharp pain in my knee, I went to my GP who gave me terrible advice (told me to play on as it should sort itself out).  It didn't and now I am in a terrible condidtion, and haven't played sports for nearly a year.  I eventually got to see a consultant, who only x-rayed me, and sent me to a physio saying there was nothing he could do.  The physio told me it was patellar tendonitis and I did an excercise program to strengthen my quads etc.  However, I did not respond well to this.  I have since seen a well respected sports injury specialist who thinks it is patellar tendonosis and has organised a proper scan on my knee.  I am unsure what the difference between patellar tendonitis and tendonosis is, and if there is any chance I will ever have a normal feeling knee again (if I can get surgery).  He mentioned the word "cysts" which freaked me out a bit.  Can anyone help/advise me please?
Posted by wend1175 (wend1175), 26 February 2004

sorry to hear about the pain your in....i also have just been diagnosed with tendonosis....i had a maquet procedure back in August 2003 and finished pt and have had still alot of pain which now they think its tendonosis....not sure of the difference but im back in pt and you do not exercise you need massage and ultrasound to try and work it out....i also understand if that doesnt work you might need surgery....sorry i couldnt help anymore but i know that massage and resting the knee help with tendonosis
Posted by ret13 (ret13), 26 February 2004

Thanks for the reply.  I'd been exercising it like mad up until now and never really knew if I should be.  I have stopped it now until I have the scan and see what's going on.  Good luck.
Posted by Beauzer (Beauzer), 26 February 2004

The chronic stuff that happens to a patellar tendon is technically tendinosis, not tendonitis (not that it really matters for most of us, though).  In tendonitis (or any type of -itis) the problem is inflammation.  That being said, the problem with most patellar tendons (except for those pretty soon post-op) is actually a tendonosis, which means there is no inflammation.  

In the case of the patellar tendon, you tend to get areas of necrosis (cell death) which can become a chronic problem and not heal.  Sometimes massage or ultrasound can help because they increase blood flow to the affected area.  In bad chronic cases, sometimes they have to cut out the bad part of the tendon so that the rest can heal (this is really uncommon, though!)

In my case, I do not have chronic tendonosis (thankfully) but rather have recurrent bouts of post-op tendonitis.

Best of luck
Danielle
Posted by Pat_A.E. (Pat_A.E.), 12 March 2004

I have also been diagnosed with severe tendenosis.  It was quite clear on the MRI.  My OS said the difference is tendenitis is inflamation and tendenosis is a shredding or holes developing in the tendon.  Since tendenosis is not inflamation anti-flamitory meds, cortisone, etc are not helpful.  Icing only helps with pain management.  The only possible cure is rest.  This means avoiding impact type of activities (joggin, running, step aerobics, volleyball, etc).  I had 6 weeks of PT using ultrasound.  It was very helpful for awhile, but the pain is increasing again.  The OS advised to avoid surgery because the results are usually not good.  
I am quite sure the tendenosis is a side effect of a patella fracture and hardware used for repair.  The hardware was removed but the resulting holes remained.  The new problem is almost more frustrating then the fracture and at times is just as painful.
Posted by badankle (badankle), 23 May 2004

Yes, I know I am a ankle problem, not a knee, but in my search to find out what tendonosis is I ended up here. 7 1/2 months ago, I sprained my ankle,   being deployed to Iraq, it isn't easy to get propper medical care, I have been diagnosed with everything from Peroneal Tendonitis, Impingment and even tondonsis. I found a wonderful website that explains tendonosis, and what can be done to help it. If you go to tendinosis.org, you might be able to get some helpful information.
Posted by JamesNimmo (JamesNimmo), 31 July 2004

hello, i am sorry to hear about ur pain, i too have been described with patella tendonosis, i also have an over stretched ACL which i was informed was my initial problem.  My (then) physio told me to continue playing rugby as long as it didn't stop me.  the problem continued to get worse so i sought extra help, my knee physio was unable to determine the problem, so i sought a specialist consultant.  i was able to see Mr El-Shazly who gaveme an MRI, i was also lucky enough to get seen by Dr Rod Jaques (Medical officer for the british olympic medical centre) who confirmed that i had patella tendonosis, Dr Jaques prescribed a rehab programme of eccentric exercises which are intended to promote regrowth in the patella tendon, the eccentric exercises he prescribed involve performing double legged squats on a 45 degree angle unitl the tendon responds with a pain response around 2-3 out of 10, these squats would then become single legged (one leg down, two up) then progressing onto adding weight.  unfortunatley the process is not a quick one and the problem should hopefully respond and heal after 3 months. hope this helps anyone,  

This old Forum was so valuable that we have kept it as an archive. It is just for reference. If you want to ask questions or offer advice, there is also a current Bulletin Board which you can access from our home page.