Gastrocnemius Tendinitis

　　The etiology of patellar tendinitis is mostly unknown. Most patients are middle-aged and elderly. Due to poor blood supply to the tendons and repeated minor injuries, they often lead to significant injuries. Repeated or severe injuries (incomplete rupture), fatigue, overwork (due to inadaptability) and other common possible causes of disease.

　　For patients with patellar tendinitis, if they do not pay attention to rest or treatment, due to excessive movement in the area of the lesion, the condition often worsens continuously. Pain is the most obvious manifestation, and in the later stage, the main complications include: chronic swelling (gravity edema); muscle atrophy; avulsion fracture; joint stiffness; ligament laxity.

　　Patellar tendinitis also has symptoms inherent in tendinitis itself, mainly manifested as tenderness in the joints or around the joints. In some cases, there may be numbness or tingling, accompanied by painful joint stiffness, limiting the movement of the affected joint. Occasionally, there may be slight swelling, persistent pain, and recurrence of tendinitis from the original injury, leading to persistent pain or recurrence much later.

　　To prevent patellar tendinitis and to help patients recover better after the disease, patients can adjust according to the following methods:

　　1. Allow the muscles to rest, but avoid resting for too long to prevent muscle atrophy.

　　2. If tendinitis is caused by exercise, changing the type of exercise can be a considerate method.

　　3. Taking a hot bath can help raise body temperature and promote blood circulation.

　　4. You can use a warm, damp towel to apply heat to the knee area.

　　5. Stretch the muscles well before and after exercise.

　　6. Wearing a knee brace can strengthen muscles and tendons.

　　7. Using ice packs can reduce swelling and pain, but those with heart disease, diabetes, or vascular problems should not use them.

　　8. Elevating the affected area can control swelling.

　　9. Taking painkillers without steroids can reduce inflammation and swelling.

　　10. Taking a short break is the best way to relieve muscle tension.

　　To rule out the possibility of bone injury, X-ray examination and bone scan should be performed in cases where it is difficult to make a diagnosis, as X-ray examination often shows calcification in the tendons and their sheaths.

　　Magnetic resonance imaging can help determine the severity of tendinitis and can accurately display it when the tendons are completely torn, which is of certain significance for differential diagnosis.

　　Patients with patellar tendinitis should consume high-protein, nutritious foods rich in vitamins and minerals, and easily digestible high-calorie foods. It is advisable to avoid eating greasy, difficult-to-digest, smoked, grilled, cold, spicy, and high-salt, high-fat foods.

　　The following methods can all alleviate the symptoms of popliteal tenosynovitis:

　　Use splints or casts to immobilize tendons or keep them at rest, apply heat or cold compresses (choose according to what is beneficial to the patient), apply local anesthetics, and use non-steroidal anti-inflammatory drugs for 7 to 10 days. Colchicine is effective in treating patients with uric acid deposits. After the acute inflammation is controlled, moderate exercise training can be performed several times a day (gradually increase the amount of active exercise according to tolerance).

　　Intratendinous injection of long-acting adrenal cortical hormone preparations is also effective. Acetate dexamethasone, methylprednisolone acetate, or hydrocortisone acetate 0.5 to 2ml, mixed with an equal amount or twice the amount of 1% local anesthetic (such as lidocaine), is selected according to the condition and location. If the site of inflammation is unclear, a试探性 injection can be performed at the site of the most severe pain. It must be noted not to inject into the tendons (at this time, there is a greater resistance), in order to avoid making the tendons weak and causing tendinous rupture during activity. After 3 to 4 days, the site of inflammation can often be found, so that a more precise second injection can be performed. Keeping the injection site at rest can reduce the risk of tendinous rupture. Patients should be informed in advance that an "acute attack after injection" may occur occasionally, which may be caused by the crystallization of long-acting adrenal cortical hormone preparations诱发滑膜炎. This phenomenon often occurs within a few hours after injection and usually does not exceed 24 hours, and can be treated with cold compress and short-acting analgesics.

　　To reduce inflammation, local injection or symptomatic treatment should be performed every 2 to 3 weeks, with a course of 1 to 2 months. For refractory cases, surgical exploration may be considered to remove inflamed tissue or calcified deposits, followed by appropriate physical therapy. In addition to fibrous bony tunnel release surgery or tenotomy for chronic inflammation, surgery is rarely required.

　　Patients should place a wedge-shaped insole inside the shoe or use an orthotic device to limit internal rotation, avoid running until the pain during running disappears, and delay the downhill running training for several weeks.