Updated: 5/29/2021

Semimembranosus Tendinitis

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  • summary
    • Semimembranosus tendinitis is the inflammation of the insertion of the semimembranosus tendon leading to activity related posteromedial knee pain.
    • Diagnosis is made clinically with tenderness to palpation at the insertion of the semimembranosus tendon made worse with passive deep flexion of the knee or internal rotation of the tibia at 90 degrees of knee flexion.
    • Treatment is nonoperative with rest, stretching and physical therapy to focus on hamstring and quadriceps strengthening. 
  • Epidemiology
    • Demographics
      • most common in male athletes
      • often occurs in patients in their early thirties
  • Presentation
    • History
      • of report recent increase in endurance activities (running or cycling)
    • Symptoms
      • pain in the posteromedial knee
        • may radiate into the posterior thigh or into the distal-medial calf
        • may be exacerbated with traversing down stairs or in deep knee flexion
    • Physical exam
      • tenderness to palpation at the tibial insertion of the semimembranosus
        • the tendon may be more prominent with resisted knee flexion at 90 degrees
      • provocative tests
        • passive deep flexion of the knee or internal rotation of the tibia at 90 degrees of knee flexion may increase pain
  • Imaging
    • MRI
      • may be helpful in making the diagnosis
    • Nuclear imaging
      • may be helpful in making the diagnosis
  • Treatment
    • Nonoperative
      • physical therapy
        • indications
          • mainstay of treatment
        • modalities
          • usually responds to stretching & strengthening of the hamstrings
      • steroid injection
        • indications
          • used as an adjunctive measure
          • it may be utilized if there is limited improvement with physical therapy
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