myosesh Musculoskeletal post Semimembranosus tendinopathy

Semimembranosus tendinopathy



This is an uncommon chronic condition caused pain in posterior-medial aspect of the knee.

The common hamstrings tendon was involved in 23% of the patients with hamstrings tendinopathy, in biceps femoris muscle in 41%, semimembranosus in 29% and semitendinosus in 6% in the study. *2

 This study also shows that 17 high-level athletes who had a surgical treatment for chronic hamstrings tendinopathy returned to play sports without pain in about 4 months.  

Aetiology

  • Young athletes owing to overuse
  • Age 40-60 patients (women>men)
  • Sudden intense activity
  • Runners, walkers and footballers

Other pathologies that may lead to semimembranosus tendinopathy

  • Degenerative medial meniscus
  • Chondromalacia (softening of the cartilage)
  • Osteoarthritis
  • Pes anserine tendinitis *4
  •  Osteophytes *4

Signs and symptoms

  • Pain in posteromedial knee
  • Pain with hamstrings activity (knee flexion, cycling and walking downstairs)
  • Tenderness or swelling on semimembranosus tendon and medial knee
  • Pain with knee internal rotation

Differential diagnosis

  • Meniscus tears
  • Snapping knee syndrome of the medial hamstrings
  • Pes anserine bursitis
  • Medial collateral ligament strain
  • Osteoarthritis
  • Popliteal cyst (Baker’s cyst)

Treatment

  • Ice
  • Modifying the activities that produce pain
  • Stretch
  • Arthroscopy
  • Corticosteroid injection

As semimembranosus tendinopathy is not a prevalent condition and case, this is prone to be overlooked which does not result in ideal outcomes. Early diagnosis will result in early successful result and early return to the sports.

Although there are not enough researches as to this condition, exercises do not seem to helpful for semimembranosus tendinopathy. *1  

References

  1. William E. Bylund, BS and Kevin de Weber Semimembranosus tendinopathy One cause of chronic Poseromedial knee Pain 2010 Sports Health 2 (5): 380-384
  2. Francesco Benazzo, Matteo Marullo, Giacomo Zanon, Christian Indiano and Francesco Pelillo Surgical management of chronic proximal hamstrings tendinopathy in athletes: a 2 to 11 years of follow-up 2013 J Orthop Traumatol 14 (2):83-89
  3. Ray M, Clancy W, Lemon R. Semimembranosus tendonitis: an overlooked cause of medial knee pain. Am J Sports Med. 1988;16:347.
  4. Halperin N, Oren Y, Hendel D, Nathan N. Semimembranosus tenosynovitis: operative results. Arch Orthop Trauma Surg. 1987;106:281-284

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