Quadriceps Tendinopathy

Quadriceps tendonitis

Overuse causes pain and inflammation of the quadriceps (thigh muscle) tendon to the point where it attaches to the top of the kneecap or patella. Over time this can lead to degeneration of the tendon. Here we explain the symptoms and causes as well as treatment and rehabilitation exercises.

Symptoms of quadriceps tendinopathy

Pain around the top of the kneecap during and after exercise. There may be a pain when simply contracting the quadriceps muscles or pressing in along the top of the knee where the muscle attaches to the patella. The patient is likely to feel stiffness the day after training and has pain when standing from a crouched position.

What is quadriceps tendinopathy?

Tendinopathies are diseases of the tendon. These can come in many forms, including tendonitis (inflammation of the tendon) and tenosynovitis (inflammation of the sheath surrounding the tendon). The term tendinopathy is used to cover most tendon injuries.

The insertion of a muscle is its lower attachment point. The quadriceps muscles insert at the top of the patella (kneecap). This injury is an overuse injury, as the pain tends to develop gradually over a period of time, rather than at a specific point. Pain in this area is more common in older athletes and in weightlifters. This is because of the high strain on the muscle insertion during deep squats.

Treatment of quadriceps tendinopathy

What can the athlete do?

Apply cold therapy or ice if it is acutely painful. Ice can be applied for 10 to 15 minutes every hour for the first 24 to 48 hours. Later once any acute inflammation has calmed down applying heat and wearing a heat retainer may be more beneficial.


Stretching the quadriceps muscles is important and should be done regularly throughout the day. A sports injury professional can advise on a full rehabilitation program. Rest is unfortunately also very important. If you do not rest, it will not get better!

What can a Sports Injury Professional do?

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.

Cross friction sports massage techniques can be particularly effective in treating chronic quadriceps tendinopathy. 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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