Tibial Collateral Ligament Bursitis

Tibial Collateral Ligament Bursitis



Description


A bursa is like a water balloon that helps reduce friction and wear between bones and soft tissue. The tibial collateral ligament (TCL) is a ligament on the inner side of the knee that connects the thigh bone to the tibia, one of the bones of the lower leg. The TCL bursa is the bursa between the TCL and the bone at the knee joint; this bursa allows the ligament to glide past the bone and cartilage at the joint. Inflammation of this bursa (bursitis) causes pain, but it is usually not associated with other knee injuries.



Common signs and symptoms



• Pain, tenderness, or swelling (occasionally) over the TCL bursa on the inner knee

• Pain that may be worse with completely straightening the knee

• Crepitation (a crackling sound) when the tendon or bursa is moved or touched


Causes


The cause of TCL bursitis is unclear, although runners, tennis players, swimmers, and cyclists are more often found to have this problem.



Factors that increase risk



• Sports such as running, tennis, swimming, and cycling


Preventive measures



• Unknown


Expected outcome


TCL bursitis is usually curable within 6 weeks if treated appropriately with conservative treatment and resting of the affected area.



Possible complications



• Prolonged healing time if not appropriately treated or if not given adequate time to heal

• A chronically inflamed bursa, causing persistent pain

• Recurrence of symptoms if activity is resumed too soon, with overuse, with a direct blow, or when using improper sports technique


General treatment considerations


Initial treatment consists of medication and ice to relieve pain; stretching and strengthening exercises, particularly for the quadriceps muscles; and modification of the activity that initially caused the problem. These exercises can be carried out at home, although referral to a physical therapist or athletic trainer for further evaluation and treatment may be helpful.


A knee sleeve or bandage may help keep the bursa warm during activity and may reduce some of the symptoms. An injection of cortisone into the bursa to reduce the inflammation, along with lidocaine to reduce pain and to confirm the diagnosis, may be recommended. Surgery is rarely needed to remove the inflamed bursa and is usually only considered after at least 6 months of conservative treatment.



Medication



• Nonsteroidal antiinflammatory medications, such as aspirin and ibuprofen (do not take for 7 days before surgery), or other over-the-counter pain relievers, such as acetaminophen, are often recommended. Take these as directed by your physician, and contact your doctor immediately if any bleeding, stomach upset, or signs of an allergic reaction occur.

• Pain relievers are usually not prescribed for this condition, although your physician will need to determine this. Do not take prescription pain medication for longer than 4 to 7 days. Use it only as directed, and take only as much as you need.

• Cortisone injections reduce inflammation, and anesthetics temporarily relieve pain.


Heat and cold



• Cold is used to relieve pain and reduce inflammation for acute and chronic cases. It should be applied for 10 to 15 minutes every 2 to 3 hours as needed and immediately after any activity that aggravates your symptoms. Use ice packs or an ice massage.

•
image

Figure 1


Heat may be used before performing stretching and strengthening activities prescribed by your physician, physical therapist, or athletic trainer. Use a heat pack or a warm soak.



When to call your doctor



• Symptoms get worse or do not improve in 2 weeks despite treatment.
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Jul 18, 2016 | Posted by in SPORT MEDICINE | Comments Off on Tibial Collateral Ligament Bursitis

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