Tibia anserin tendinopathy

Patient: Male, 28 years old. Football player. Comes up to consultation due to an acute pain on his knee, mostly when shooting the ball, that started about 1 month ago and has increased since then. He locates the pain in the Pens aserinus.

There is no inflammation or bruise in the visual exploration.

His pain appears when palpation in the spot, not in different spots arround though. There is a pain of 8 out of 10 in the visual analogue scale both when shooting the ball and pressing the spot.

Tests used to assess the state of the knee do not show a lack of stability or an increased pain (Lachman test, MCL, LCL, PCL and Apley test for meniscus).

Ultrasound image shows the inflammation and degenerative changes in the anserin tendon, probably in the gracilis section. The inflammation seen in the ultrasound image coincides with the painful spot.

Picture 1: Swollen spot in the Pens anserinus

It is decided to treat the tendon with needles and electrical current in order to achieve a quick heeling.

Access to the injured section of the tendon is made both from above and below the spot. Needles used are 0'32 x 40 mm size. The patient feels an increase of the pain when the needle touches the swollen spot, thereby it is confirmed that this the point to be treated.

6 cycles of 8 seconds of electrical current are applied in the swollen spot. Microwave is used afterwards in order to stimulate tendon's metabolism.

One week later the patient has improved and he feels a pain of 4 out of 10 in the V.A.S. both when shooting the ball and pressing the painful spot.