Tendinitis rotuliana. Por Dr. David Sznajderhaus


Tendinitis rotuliana, como su nombre lo indica es la inflamación del tendón rotuliano. Recordemos que la terminación itis, en medicina significa inflamación. El tendón rotuliano, es la porción terminal del músculo cuádriceps que conforma la región anterior del muslo. El músculo cuádriceps, está formado por cuatro músculos distintos y todos ellos terminan en un tendón en común que es el rotuliano.

Si tuviéramos que describir los limites de este tendón, los encontraremos en el polo o punto inferior de la rotula y la tuberosidad anterior de la tibia, que es una saliente del hueso que se toca justo cuando termina la rótula de la rodilla, en la cara anterior de la pierna, de esta forma el tendón rotuliano es una estructura en forma de cinta, de unos 3 a 5cm de largo y otros 2cm de ancho. Mecánicamente es un tendón de muchísima fuerza y su mayor esfuerzo lo realiza en los movimientos de flexión o al doblar la rodilla cargando el peso del cuerpo sobre esa pierna.

El mecanismo de lesión es la mayoría de las veces una sobrecarga por micro traumatismo a repetición (algo así como la tortura china de la gotita de agua sobre la frente, 10 minutos no pasa nada, en 2 días te aniquila).

Una pequeña alteración en los ejes de apoyo al correr, zapatilla de mala calidad o vencidas, etc.; repetida por la cantidad de pasos que uno hace por Km., multiplicado por el Km semanal de un par de meses, suele producir esto.

Además, factores como un músculo cuádriceps debilitado, unos isquiotibiales faltos de flexibilidad suelen agravar y precipitar este problema. Los primeros síntomas son dolor persistente en reposo al mantener posiciones fijas por algún tiempo prolongado, intermitencia en la intensidad del dolor, que por momentos lo hace solo una molestia y en otras ocasiones lo vuelve insoportable.
No suele haber inflamación de la rodilla, no suele estar colorada ni hincharse.

Leer más: Cervicalgia. Por Dr. David Sznajderhaus

Lo primero que hay que hacer, es disminuir la causa que suele aumentar el momento de dolor, y generalmente esta relacionado al entrenamiento, por lo que se impone el reposo deportivo hasta que el dolor desaparezca y si no es muy intenso, reducir intensidades de entrenamiento.

El frió como antinflamatorio local suele ser de mucha ayuda, y debe colocarse por periodos entre 20 y 30 minutos 2 a 3 veces al día los dos o tres primeros días acompañada de analgésicos y antiinflamatorios al mismo tiempo.

La infiltración es un recurso muy válido que evaluará solamente el especialista cuando los demás métodos no resulten. Habitualmente, con el tratamiento propuesto, este problema se soluciona. En algunos casos, la kinesiología aporta muchísimo.

Tiempo de curación y rehabilitación: Esta lesión así como tiene una aparición lenta e insidiosa, sin tratamiento, tarda mucho en irse y tiene una recuperación muy lenta.

Con tratamiento puede resolverse en el corto plazo. La vuelta a la actividad normal puede demorar de 2 a 4 semanas, dependiendo de cada caso en particular, del estado previo, de la actividad muscular, de la contextura muscular. Hay actividades que uno puede incluir en el plan de entrenamiento y posiblemente ayuden a una recuperación más rápida por ejemplo la bicicleta y la natación, pueden ser intercaladas en el plan de entrenamiento y los resultados suelen ser muy satisfactorios.

En síntesis, la tendinitis rotuliana es muy frecuente, su comienzo es muy lento e imperceptible por lo que su recuperación puede demorar. Lo que uno puede hacer por si mismo es mucho. Bajar el entrenamiento, otras actividades y hielo es de mucha ayuda. El diagnóstico y el tratamiento más específico deben quedar como siempre decimos, bajo responsabilidad médica. Eviten los remedios caseros, la cáscara de huevo, las vendas avinagradas, no sirven de nada. Solo el consejo oportuno y aplicado de tú médico, te podrá solucionar este problema.

Dr. David Sznajderhaus (www.docterapi.com)

Médico MN 70.630

Médico Deportólogo


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