Quadriceps tendonitis is inflammation of the tendon of the quadriceps (thigh) muscle, where it inserts at the top of the patella. Here we explain the symptoms, causes and treatment of Quadriceps tendonitis.
Symptoms of quadriceps tendonitis
Quadriceps tendinopathy symptoms consist of:
- Pain along the top edge of the patella (kneecap) which is felt during and after exercise.
- You may even have pain simply contracting the quadriceps muscles when sitting in a straight leg position.
- Your knee will feel tender when pressing in (palpating) along the top of the patella, where the muscle attaches to the bone.
- It is likely your knee will feel stiff the day after exercise, especially first thing in the morning.
- You will probably have pain when standing up from a squat position.
What is quadriceps tendonitis?
Quadriceps tendonitis is inflammation of the tendon of the quadriceps (thigh) muscles. The quadriceps muscle group are the four large muscles at the form of the thigh and consist of the rectus femoris, vastus lateralis, vastus medialis and the vastus intermedius. When they contract the bend (flex) the knee.
The rectus femoris is the largest muscle and also flexes the hip (lifts the thigh) because it originates from the pelvis, crossing both the hip joint and the knee joint (called a biaxial muscle).
The quadriceps muscles join together in a common tendon which attaches to the patella or kneecap, which in turn inserts into the front of the tibia or shin bone.
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Tendonitis or tendinopathy?
Tendonitis is inflammation of a tendon (‘itis’ means inflammation). If an injury is fairly recent or acute then it may be inflamed. But many long term, chronic injuries are more likely to have wear and tear or degeneration. Acute, inflammatory cells are no longer present as they would be in a very recent injury.
The word tendinopathy simply means ‘diseases of the tendon’ and so describes a range of conditions. These include:
- Quadriceps tendonitis (acute inflammation).
- Tenosynovitis (inflammation of the sheath surrounding the tendon).
- Degeneration of the tendon from overuse or ‘wear and tear’.
The term quadriceps tendinopathy is used to cover most tendon injuries.
Treatment of quadriceps tendinopathy
The aims of treatment and rehabilitation are to decrease pain and inflammation, stretch the quadriceps muscles and gradually increase the load through your tendon as you return to full fitness.
Cold therapy & compression
Apply cold therapy or ice if your knee is acutely painful. Ice can be applied for 10 to 15 minutes every hour for the first 24 to 48 hours.
Do not apply ice directly to the skin as it may burn. Use a wet tea towel or better still, a commercially available reusable hot and cold pack.
Later once any acute inflammation has calmed down, applying heat and wearing a heat retainer may be more beneficial.
Rest is very important. This may mean complete rest, or active rest. Active rest is often suitable for a less severe injury and involves modifying the type of training you do. For example, avoid explosive jumping or plyometric activities for a few weeks.
If your knee is painful even during training then a complete period of rest may be required. For more recent acute injuries a rest period of 2 to 4 weeks may be sufficient. If you have a long term chronic injury then a sustained period of rest may be required.
Stretching the quadriceps muscles is important and should be done regularly throughout the day. Strengthening exercises, in particular eccentric strengthening may be beneficial, but in the early stages and for acute injuries, rest is the priority.
A sports injury professional can advise on a full treatment and rehabilitation program.
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For particularly chronic tendinopathies, cross friction sports massage techniques can be particularly effective.
Self-massage can be done by applying short, frictions across the tendon along the top of the patella for 5 to 10 minutes.
The aim is to gradually apply firmer frictions to reduce adhesions between the tendon and its surrounding sheath. It is likely you will feel particularly sore spots as thicker areas of the tendon.
A doctor may prescribe anti-inflammatory medication (e.g. Ibuprofen) in the early acute stages, however, if this injury is a long-term chronic problem then anti-inflammatory medication may not be beneficial and may even hinder recovery.
Always check before you take medication. You should not take Ibuprofen if you have Asthma.
In persistent cases, a doctor may give a corticosteroid injection. Recovery from chronic quadriceps tendinopathy can take weeks or even months.
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