Overuse problems of the knee :
acupuncture for tendinosis? - - Posted by soccergal28 (soccergal28), 26 March 2004
i have had a LR, a TTT, and hardware removal on my left knee in the past year. for the past few months, i have had severe stabbing pain directly on the patella tendon. my doctor now believes that i have patella tendinosis. i have tried ultrasound, iontophoresis, (painful) massage, icing, etc. i am now on bextra, which i believe is an anti-inflammatory, and i am wearing an immobilizer at school (should i use crutches as well?). none of this has had any effect. im only 15, and im tired of sitting on the sidelines. my doctor has now recommended acupuncture, as a last resort, but i am a bit skeptical. i am very willing to try it, but i would be interested to know of the experiences of others. also, any other suggestions would be greatly appreciated. thanks!
Posted by inpain (inpain), 3 April 2004
hi,
i am very sorry to hear about ure knee.i know how frustrating it can be and u're too young to be going thru all this.how did it start?
i had 25 percent of my medial meniscus removed two months ago.looks like i will be needing another surgery on my right knee now.
i had tried acupunture for three months for the tear.it didnt help me one bit.but at the clinic i had seen people walk in with terrible problems and walk out fully cured after 10days.my doctor hadnt had any experience with tears and i sppse it doesnt work for it.i really think u should speak to an acupunturist and go for it if u feel hes had enough experience with your kind of problem.
you could even give homeopathy and ayurvedha a shot, these have no side effects and are painless and work very well for certain conditions.
hope your feeling better real soon.
-
Posted by soccergal28 (soccergal28), 3 April 2004
my problems started about two years ago. i was playing soccer 4-5 hours daily and had been having a dull ache in the knee for a few months. i play in goal, and i went to save a high shot. when i landed on it, and out it popped. it wasnt a complete dislocation, but it came pretty close. since then ive been in pt pretty much all the time, and ive had a LR, a TTT, and a screw removal, after the dislocating got more frequent (and complete).
i did go to the acupuncturist on tuesday. i didnt havent felt any relief yet, but i am trying to be optimistic. my pain is still getting worse, however, and my pt decided to call my doctor, who hasnt called back. im having trouble getting around at school, so i hope theres something that he can do. i have tried homeopathy before. it wasnt doing any good and my GP made me stop because she said it wasnt proven and could interfere with the other meds i was on. i am going back for more acupuncture on tuesday, and im hoping that im a "fast responder" as my acupuncturist described it. im sorry it hasnt worked for you, and good luck on your surgery. thanks for the reply!
Posted by allstardiva2005 (allstardiva2005), 8 May 2004
on 03/26/04 at 00:39:18, soccergal28 wrote:i have had severe stabbing pain directly on the patella tendon. my doctor now believes that i have patella tendinosis. i have tried ultrasound, iontophoresis, (painful) massage, icing, etc. i am now on bextra, which i believe is an anti-inflammatory, and i am wearing an immobilizer at school (should i use crutches as well?). none of this has had any effect. im only 15, and im tired of sitting on the sidelines.
you sound just like me. except i've had different surgeries than you (acl and 3 meniscus-related ones). i'm 17, but i was on bextra for the past 3 weeks, have had ultrasounds, iontophoresis, etc. crutches may help ease the pain for you. but i just saw a surgeon today and she diagnosed me w/ patellar tendonitis and pes anserine tendonitis along with PFS...i'm supposed to try and push through the pain and really build up my quads.
have your quads atrophied a great deal from surgeries? b/c mine have about 40% and it seems like a vicous cycle: i need to work out to build muscle to make it hurt less but it hurts so much that i can't work out.
and my med was changed from bextra to naprophen (i think that is what its called?)- maybe try switching med and maybe that would help somewhat? i hope you can find something to make it feel better! i totally understand what your going through- and it sucks. 
Posted by soccergal28 (soccergal28), 8 May 2004
i know all about the 'vicious cycle' my quads were pretty atrophied, but ive built them up more now. i still need to get them stronger, but the pain is so intense when i use them that i avoid it, even though i know i shouldnt. i went to my surgeon last week, and he decided that it didnt seem like tendinosis anymore, since i was also having bone pain in the tibia. i also went to a pain clinic where they diagnosed me with neuropathic pain, which they said would take 1-2 years to heal since my nerves are so damaged from the three surgeries within a year. im off bextra now, and ive been on neurontin for awhile, which they just tripled. i also have a tens unit, which the doc at the pain clinic said to use all the time at school. it doesnt help much now, but they said as soon as everything else starts to work the difference it makes will be more obvious. as for the acupuncture, i had an extremely painful session last week (i was in tears) and since then the pain has skyrocketed. at the pain clinic they explained that the needles shouldnt have been placed around my knee, and thats what caused the pain!!!
Posted by insomnia80 (insomnia80), 31 August 2004
Hey glad to know I'm not alone with this. How are you doing? I've seen two orthopedics who've diagnosed me with pes anserine tendonitis and don't know what to do. Then I'm dealing with work comp, so I don't get to see good docs. What type of quad strength and stretching do you do? I can't find any info on what to do to treat it. I injured my knee in dec of 03 and went through the same PT you did(but for petalla tendonitous the first time) and nothing helped. I'm allergic to all anti- inflamitories, and work comp won't let me have anymore PT, so it's not fun. thanks
stacey
staceyzimm88l55@hotmail.com
Posted by hmaxwell (Heather M.), 31 August 2004
For those with ongoing 'tendinitis' or 'tendinosis' issues after knee surgery, have you all been thoroughly x-rayed, MRI'd, and examined for possible mechanical issues following your surgeries?
I just ask because I went through lateral release, menisectomy, removal of meniscal cyst, and patellar shaving. I rehabbed well initially, but then started getting shooting pain below my knee and wasn't able to do an quad strengthening stuff. Eventually it got to the point where I could duplicate the stabbing pain just by doing a simple quad set.
My doctor and PT chased the 'tendinitis' theory for a while--months. But my knee didn't respond to any of the treatments that normally work quite well on tendinitis.
It turns out that my patellar tendon WAS inflamed and irritated, but only because it was wrapped up in an cocoon of scar tissue. The adhesions filled the space under my kneecap, behind my patellar tendon, and wrapped around it completely. This caused the tendon to become irritated, inflamed, and eventually to shrink and contract due to the trauma. As the tendon shrank down and contracted, it pulled my kneecap down and out of place in a condition called patella baja. This creates instant arthritis--bone on bone contact. It also causes lots of sharp pain below the knee (where the kneecap is located, but isn't supposed to be).
So anyway, anytime I read about someone with tendinitis that just lingers and lingers and doesn't respond to any treatment, I get suspicious. If my OS had just taken x-rays he would have seen what my problem was right away. The best treatment for patella baja is to prevent it.
If you are having ongoing issues, make sure your doctor and PT are looking at all the potential issues you could have--and a few that you 'couldn't possibly have!' The doctor never even considered scar tissue in my case because I just had a 'minor scope.' No big deal...he'd never heard of anyone having scar tissue after such a 'small' procedure (my foot, it's small!)
So if your doctors aren't able to figure out what's going on, and if nothing you are trying is curing your potential tendinitis, maybe you should ask what else your problem could be...?
Best of luck sorting this out. My patellar tendon has moved beyond tendinitis and into full on tendinosis as well. I have bits of nasty, non-tendon tissue on it, it's wrapped in scar tissue, and my new doctor's fellow joked that my tendon had the texture and appearance of a tootsie roll!
Take care, and start to ask questions. If your doctor can't answer them, find one who can.
Heather
PS I find acupuncture and myo-fascial release combined TOGETHER with PT modalities like phonophoresis provided a LOT of improvement in my tendon irritation. I'd go to the doctor and she would do acupuncture, then I 'd hop in the car and do PT with deep tissue work (ow) on my knee and IT band followed by phonophoresis, which is ultrasound with cortisone cream (heaven!). Then I'd go to the room next door to see a specialised massage called ROLF work. It hurt so good. But first you need to get everything to calm down, which is why rest is important.
Updated Sat Sep 6 2008