Quadriceps Tendon Rupture

Rectus femoris muscle

Ruptures of the quadriceps tendon mainly occur in middle aged individuals during sporting activities. The most common mode of injury is landing from a jump.

What are the symptoms?

Symptoms of a quadriceps tendon rupture include a sudden pain at the time of injury, although this is not always obvious in mild cases. Pain and stiffness the next day is common in tendon ruptures. The patient may be unable to weight bear or the knee may give way. Some swelling and possibly bruising may be seen just above the knee joint. At the time of injury there may have been an audible crack or pop and the patella may be seen to move downwards, in the direction of the foot.

Quadriceps tendon rupture explained

The quadriceps muscle is composed of four different muscles: the vastus intermedius, vastus medialis, vastus lateralis, and rectus femoris. These muscles converge just above the patella (kneecap) and form an extremely strong tendon, known as the quadriceps tendon. This attaches into the upper surface of the patella.

The quadriceps muscle group function in extending (straightening) the knee joint. They are also vital for the overall stability of the legs during movement, working in conjunction with the hamstrings to keep the body balanced.

Ruptures of the quadriceps tendon mainly occur in middle aged individuals during sporting activities. The most common mode of injury is landing from a jump as this leads to excessive loading on the quadriceps tendon causing it to tear. Most ruptures occur at a point between 0-2cm above the patella.

This injury usually comes secondary to degenerative changes in the quadriceps tendon itself. These changes may be due to ageing but the risk of injury is highly increased in individuals with other medical conditions such as obesity and diabetes or those who have had previous steroid injections.

Treatment of quadriceps tendon rupture

Apply RICE (rest, ice, compression, elevation) immediately. Ice should not be applied directly to the skin. Commercially available cold packs and wraps are often more convenient. Ice can be applied for 10 to 15 minutes every hour during the acute phase which is usually 24 to 48 hours depending on how bad the injury is.

Use an elasticized compression bandage around the injury to help reduce any swelling and proect the knee. Later after the acute phase a neoprene knee support or heat retainer may be more effective.

A sports injury professional may use electrotherapy treatment such as ultrasound and TENS. Sports massage may also be beneficial. Cross friction massage techniques to the tendon may help with correct scar tissue formation. After the acute stage heat will help stimulate blood flow and aid the healing process.

When pain allows a full stretching and strengthening rehabilitation program  should be undertaken and continued once full fitness has been achieved.

In cases where there has been a severe or complete tear of the tendon, surgery is required. If the tendon has been pulled off the patella, it is sutured (stitched) firmly back in place. Following surgery the knee must remain immobilized in a knee brace and non-weight bearing is usually advised for a number of weeks. Prescribed rehabilitative exercises should be followed once the rupture has healed sufficiently.