Display options
Cite
Sederberg M, LaMarche L, Skinner L, et al. Distal semimembranosus tendinopathy: A narrative review. PM R. 2021;doi: 10.1002/pmrj.12667.
Sederberg, M., LaMarche, L., Skinner, L., & Cushman, D. M. (2021). Distal semimembranosus tendinopathy: A narrative review. PM & R : the journal of injury, function, and rehabilitation, . https://doi.org/10.1002/pmrj.12667
Sederberg, Mark, et al. "Distal semimembranosus tendinopathy: A narrative review." PM & R : the journal of injury, function, and rehabilitation vol. (2021). doi: https://doi.org/10.1002/pmrj.12667
Sederberg M, LaMarche L, Skinner L, Cushman DM. Distal semimembranosus tendinopathy: A narrative review. PM R. 2021 Jul 04; doi: 10.1002/pmrj.12667. Epub 2021 Jul 04. PMID: 34218525.
Copy Download .nbib Format: NLM
Share it on

PM R. 2021 Jul 04; doi: 10.1002/pmrj.12667. Epub 2021 Jul 04.

Distal semimembranosus tendinopathy: A narrative review.

PM & R : the journal of injury, function, and rehabilitation

Mark Sederberg, Laura LaMarche, Lee Skinner, Daniel M Cushman

Affiliations

  1. Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, Utah, USA.
  2. Department of Physical Therapy, University of Utah, Salt Lake City, Utah, USA.

PMID: 34218525 DOI: 10.1002/pmrj.12667

Abstract

Distal semimembranosus tendinopathy is a relatively uncommon diagnosis that can be responsible for medial knee pain. The semimembranosus tendon inserts on the posteromedial knee and is surrounded by the semimembranosus bursa, with both the bursa and tendon potential sources of pain. Similar to other tendinopathies, semimembranosus tendinopathy often occurs with overuse of the musculotendinous unit and is commonly seen in runners. Diagnosis can be made clinically and may be substantiated with use of ultrasound or magnetic resonance imaging. Scant literature exists evaluating the efficacy of treatments for this condition. Consequently, best practice for treatment is inferred from other similar tendinopathies, clinical expertise, and smaller studies on semimembranosus tendinopathy. Extrapolating from other tendinopathies, rehabilitation should be the cornerstone of initial treatment, with focus on kinetic chain and gait abnormalities, hamstring strength and neuromuscular control, and progressive tendon loading. Recalcitrant cases with a coexisting bursopathy can be treated with an ultrasound-guided bursal corticosteroid injection. Future studies may help delineate the optimal treatment regimen for this relatively uncommon diagnosis.

© 2021 American Academy of Physical Medicine and Rehabilitation.

References

  1. de Maeseneer M, Shahabpour M, Lenchik L, et al. Distal insertions of the semimembranosus tendon: MR imaging with anatomic correlation. Skeletal Radiol. 2014;43(6):781-791. - PubMed
  2. Jbara M, Maimon R, Padron M, et al. The distal semimembranosus complex: normal MR anatomy, variants, biomechanics and pathology. Skeletal Radiol. 2003;32(8):435-445. - PubMed
  3. Benninger B, Delamarter T. Distal semimembranosus muscle-tendon-unit review: morphology, accurate terminology, and clinical relevance. Folia Morphol. 2013;72(1):1-9. - PubMed
  4. Cavaignac E, Sylvie R, Teulières M, et al. What is the relationship between the distal semimembranosus tendon and the medial meniscus? A gross and microscopic analysis from the SANTI study group. Am J Sports Med. 2020;31:1-8. - PubMed
  5. House CV, Connell DA, Saifuddin A. Posteromedial corner injuries of the knee. Clin Radiol. 2007;62(6):539-546. - PubMed
  6. Gabbett TJ, Kennelly S, Sheehan J, et al. If overuse injury is a ‘training load error’, should undertraining be viewed the same way? Br J Sports Med. 2016;50(17):1017-1018. - PubMed
  7. O'Toole ML. Prevention and treatment of injuries to runners. Med Sci Sports Exerc. 1992;24(9 Suppl):S360-S363. - PubMed
  8. Maffulli N, Reaper J, Ewen SW, Waterston SW, Barrass V. Chondral metaplasia in calcific insertional tendinopathy of the Achilles tendon. Clin J Sport Med. 2006;16(4):329-334. - PubMed
  9. Cook J, Purdam C. Is compressive load a factor in the development of tendinopathy? Br J Sports Med. 2012;46(3):163-168. - PubMed
  10. Benjamin M, Qin S, Ralphs JR. Fibrocartilage associated with human tendons and their pulleys. J Anat. 1995;187(Pt 3):625-633. - PubMed
  11. Dean BJF, Dakin SG, Millar NL, Carr AJ. Review: emerging concepts in the pathogenesis of tendinopathy. Surgeon. 2017;15(6):349-354. - PubMed
  12. Benjamin M, Ralphs JR. Fibrocartilage in tendons and ligaments - an adaptation to compressive load. J Anat. 1998;193(4):481-494. - PubMed
  13. Bylund WE, de Weber K. Semimembranosus tendinopathy. Sport Health A Multidisc Approach. 2010;2(5):380-384. - PubMed
  14. Ray JM, Glancy WG, Lemon RA. Semimembranosus tendinitis: an overlooked cause of medial knee pain. Am J Sports Med. 1988;16(4):347-351. - PubMed
  15. Hendel D, Weisbort M, Garti A. Semimembranosus tendonitis after total knee arthroplasty - good outcome after surgery in 6 patients. Acta Orthop Scand. 2003;74(4):429-430. - PubMed
  16. Halperin N, Oren Y, Hendel D, Nathan N. Semimembranosus tenosynovitis: Operative results. Arch Orthop Trauma Surg. 1987;106(5):281-284. - PubMed
  17. Freisinger G, Schmitt L, Wanamaker A, Siston R, Chaudhari A. Tibiofemoral osteoarthritis and varus-valgus laxity. J Knee Surg. 2017;30(05):440-451. - PubMed
  18. Alvarez-Nemegyei J. Risk factors for pes anserinus tendinitis/bursitis syndrome. JCR J Clin Rheumatol. 2007;13(2):63-65. - PubMed
  19. Kang I, Han SW. Anserine bursitis in patients with osteoarthritis of the knee. South Med J. 2000;93(2):207-209. - PubMed
  20. Weiser HI. Semimembranosus insertion syndrome: a treatable and frequent cause of persistent knee pain. Arch Phys Med Rehabil. 1979;60(7):317-319. - PubMed
  21. Bianchi S, Baert AL, Abdelwahab IF, et al. Ultrasound of the Musculoskeletal System. New York, New York: Springer; 2007. - PubMed
  22. Yoon MA, Choi J-Y, Lim HK, et al. High prevalence of abnormal MR findings of the distal semimembranosus tendon: contributing factors based on demographic, radiographic, and MR features. Am J Roentgenol. 2014;202(5):1087-1093. - PubMed
  23. Beall DP, Ly JQ, Wolff JD, et al. Cystic masses of the knee: magnetic resonance imaging findings. Curr Probl Diagn Radiol. 2005;34(4):143-159. - PubMed
  24. Onishi K, Sellon JL, Smith J. Sonographically guided semimembranosus Bursa injection: technique and validation. PM R. 2016;8(1):51-57. - PubMed
  25. Yukata K, Yamanaka I, Ueda Y, et al. Medial tibial plateau morphology and stress fracture location: a magnetic resonance imaging study. World J Orthop. 2017;8(6):484-490. - PubMed
  26. Mountjoy M, Sundgot-Borgen JK, Burke LM, et al. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Br J Sports Med. 2018;52(11):687-697. - PubMed
  27. Almekinders LC, Deol G. The effects of aging, Antiinflammatory drugs, and ultrasound on the in vitro response of tendon tissue. Am J Sports Med. 1999;27(4):417-421. - PubMed
  28. Åstrom M, Westlin N. No effect of piroxicam on achilles tendinopathy. Acta Orthop. 1992;63(6):631-634. - PubMed
  29. Goom TS, Malliaras P, Reiman MP, Purdam CR. Proximal hamstring tendinopathy: clinical aspects of assessment and management. J Orthop Sport Phys Ther. 2016;46(6):483-493. - PubMed
  30. Green B, Bourne MN, van Dyk N, Pizzari T. Recalibrating the risk of hamstring strain injury (HSI): a 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport. Br J Sports Med. 2020;54(18):1081-1088. - PubMed
  31. Jesus JF, de Bryk FF, Moreira VC, Nakaoka GB, Reis AC dos, PRG L. Gluteus Maximus inhibition in proximal hamstring tendinopathy. Med Express. 2015;2(4):1-5. - PubMed
  32. Jayaseelan DJ, Moats N, Ricardo CR. Rehabilitation of proximal hamstring tendinopathy utilizing eccentric training, lumbopelvic stabilization, and trigger point dry needling: 2 case reports. J Orthop Sport Phys Ther. 2013;44(3):198-205. - PubMed
  33. Kongsgaard M, Kovanen V, Aagaard P, et al. Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Scand J Med Sci Sports. 2009;19(6):790-802. - PubMed
  34. Malliaras P, Cook J, Purdam C, Rio E. Patellar tendinopathy: clinical diagnosis, load management, and advice for challenging case presentations. J Orthop Sport Phys Ther. 2015;45(11):887-898. - PubMed
  35. Rio E, Kidgell D, Purdam C, et al. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med. 2015;49(19):1277-1283. - PubMed
  36. Rio E, van Ark M, Docking S, et al. Isometric contractions are more analgesic than isotonic contractions for patellar tendon pain. Clin J Sport Med. 2017;27(3):253-259. - PubMed
  37. Pearson SJ, Stadler S, Menz H, et al. Immediate and short-term effects of short- and long-duration isometric contractions in patellar tendinopathy. Clin J Sport Med. 2018;30(4):335-340. - PubMed
  38. Lim HY, Wong SH. Effects of isometric, eccentric, or heavy slow resistance exercises on pain and function in individuals with patellar tendinopathy: a systematic review. Physiother Res Int. 2018;23(4):e1721. - PubMed
  39. Encarnación-Martínez A, Sanchis-Sanchis R, Pérez-Soriano P, García-Gallart A. Relationship between muscular extensibility, strength and stability and the transmission of impacts during fatigued running. Sport Biomech. 2020;1-17. - PubMed
  40. Dicharry J. Kinematics and kinetics of gait: from lab to clinic. Clin Sports Med. 2010;29(3):347-364. - PubMed
  41. Malliaras P, Barton CJ, Reeves ND, Langberg H. Achilles and Patellar tendinopathy loading programmes. Sport Med. 2013;43(4):267-286. - PubMed
  42. Schubert AG, Kempf J, Heiderscheit BC. Influence of stride frequency and length on running mechanics. Sport Health A Multidisc Approach. 2014;6(3):210-217. - PubMed
  43. Schuermans J, van Tiggelen D, Palmans T, Danneels L, Witvrouw E. Deviating running kinematics and hamstring injury susceptibility in male soccer players: cause or consequence? Gait Posture. 2017;57:270-277. - PubMed
  44. Alizadeh S, Mattes K. How anterior pelvic tilt affects the lower extremity kinematics during the late swing phase in soccer players while running: a time series analysis. Hum Mov Sci. 2019;66:459-466. - PubMed
  45. Danielsson A, Horvath A, Senorski C, et al. The mechanism of hamstring injuries-a systematic review. BMC Musculoskelet Disord. 2020;21(1):641. - PubMed
  46. Grimaldi A, Mellor R, Hodges P, Bennell K, Wajswelner H, Vicenzino B. Gluteal tendinopathy: a review of mechanisms, assessment and management. Sport Med. 2015;45(8):1107-1119. - PubMed
  47. Grimaldi A, Fearon A. Gluteal tendinopathy: integrating Pathomechanics and clinical features in its management. J Orthop Sport Phys Ther. 2015;45(11):910-922. - PubMed
  48. Ahmad CS, Redler LH, Ciccotti MG, Maffulli N, Longo UG, Bradley J. Evaluation and management of hamstring injuries. Am J Sports Med. 2013;41(12):2933-2947. - PubMed

Publication Types