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Quadriceps Tendonitis

With the knee being involved in every weight-bearing movement we make, quadriceps tendonitis can often take over people’s lives. In this article, we outline what the condition is, and the fastest way to heal it.

What is quadriceps tendonitis?

The quadriceps tendon is the larger tendon just above the knee. Its soft tissue structure connects the four quadriceps muscles to the knee cap (patellar) which then attaches to the shin bone via the patellar tendon. This complex is called the quadriceps mechanism which helps perform extension of the knee. When a tendon becomes inflamed, it is classed as quadriceps tendonitis or quadriceps tendinopathy.

Symptoms of quadriceps tendonitis

  • Knee pain during and after exercise which is located just above the kneecap.
  • Tender to touch.
  • Burning sensation in the area.
  • Stiffness the next day after exercise.
  • Pain standing up from a squat position.

Causes of quadriceps tendonitis

Tendons often become inflamed as a result of them having to over-work or absorb too much shock from weight-bearing activities.

Overuse

The most common causes are repetitive activities such as running and squatting. They can put a lot of repetitive stress through the knee joints and can cause a number of different overuse injuries, including quadriceps tendonitis. When the quadriceps muscles start to tire, the tendon has to then work harder which can lead to inflammation.

Misalignments

A misalignment of the pelvis can cause a leg length difference which results in more bodyweight being distributed on one leg more than the other. With the average individual performing 6000-10,000 steps a day, many of the structures in the leg bearing more weight can become inflamed, including the quadriceps tendon.

Direct blow

A direct blow from a fall or sporting activity can cause the tendon to become inflamed.

Muscle weakness

If the quadriceps muscles are weak, then they aren’t able to absorb shock very well. Some of this shock then gets transferred into the tendon which can lead to damage over time. Also, if the hamstring muscles are weak then it causes muscle imbalances and overuse of the quadriceps.

Risk factors

  • Previous injuries such as quadriceps muscle tears or jumper’s knee.
  • A lack of stretching of the large muscles of the leg before and after physical activity.
  • Muscle imbalances or weakness. The most common imbalance is caused by weakness of the vastus medialis muscle.

Nonsurgical treatment options for quadriceps tendonitis

Prolozone Therapy

The quadriceps tendon has a poor blood supply, so it doesn’t receive the same level of oxygen and nutrients compared to muscles. Prolozone Therapy is a natural treatment that involves the injection of an activated form of oxygen and nutrient to aid the healing process. It does this by reducing inflammation, improving blood supply, and stimulating the production of healing compounds called fibroblasts. Prolozone Therapy can have a regenerative and anti-inflammatory affect for a variety of different knee injuries.

Physiotherapy

A physical therapist at a sports medicine clinic will prescribe a rehabilitation program that will involve strengthening exercises for the quadriceps muscle. The exercises will help to take some of the force away from the tendon during walking and sports activities. More advanced practitioners may use electrical stimulation to enhance the effects of the exercises as part of the treatment plan. They can also apply taping on the muscle to provide additional support.

Medication 

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help to reduce inflammation, although they will not fix the tendinitis. It is advised only to take them as a last resort due to the side effects that they can have.

Diagnosis

A physical therapy practitioner will first perform a physical exam of the knee joint and quadriceps tendon. If they suspect that there may be a tear they will advise an ultrasound scan or MRI scan. If a partial tear has been identified then Prolozone Therapy and help it to repair. If a full tendon rupture is identified then arthroscopic surgery is required to reattach it. An x-ray scan is not useful for this condition.

Prevention

  • It is important to warm-up and stretch the leg muscles before and after physical activity.
  • If you are a keen runner, then regular massage of the quadriceps at a physical therapy clinic will help to take some pressure off both the quadriceps tendon and the patella tendon. Massage of the hamstring will also help to support the overall functioning of the knee joint.
  • Perform regular strengthening exercises for the large muscles of the leg to ensure that they can support the knee effectively. Ensure that you warm-up before performing any explosive strength work. A physical therapist can help to provide advice on the right type of exercises if you are unsure.
  • If you have unstable ankles then this can cause overuse of the knee and the quadriceps tendon. Orthotics in your shoes can help to stabilise the ankles in order to prevent tendon injuries and other knee problems. If you are unsure about which orthotics to choose then a physical therapist will be able to make a recommendation.
  • Activity modification – if you perform a repetitive sporting or occupational activity then it is advised to modify it until the quadriceps tendonitis has healed.
  • If you have a history of knee pain or tendinitis then it is wise to wear a splint or neoprene brace during repetitive weight-bearing activities, especially if you are an older athlete. It can also help to keep the kneecap in the correct alignment.
  • For individuals that don’t like wearing splints of braces then another option can be Kinesio taping.

Frequently asked questions

Does quadriceps tendonitis require surgery?

Quadriceps tendonitis does not require surgery. Arthroscopy surgery is only recommended if there has been a complete tendon tear.

Will a knee brace help quadriceps tendonitis?

Yes a knee brace can help to stablise the knee if someone is suffering from quadriceps tendonitis.

Does quadriceps tendonitis go away?

The condition can go away with the right treatment and advice from a trained practitioner.

Can you walk with quad tendonitis?

It is okay to walk with quad tendonitis if it is not causing you pain. If you attempt to walk through any pain then the limping postures can start to cause pain in other areas of the body such as the hip and lower back.

Can a quadriceps tendon tear heal itself?

It is hard for a quadriceps tendon tear to heal itself as it has a poor blood supply and is under constant strain from an individual’s body weight during weight-bearing activities.

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