The quadriceps tendon is a thick, strong tendon that can withstand a good amount of force. In daily life, it acts as part of the extensor mechanism to straighten the knee.
People who injure the extensor mechanism may tear the quad tendon, tear the patellar tendon, or fracture the kneecap. All of these injuries have comparable treatments and rehabilitation plans.
The Quadriceps Tendon
The quadriceps tendon (quad tendon) is the large tendon just above your kneecap. The quad tendon is part of the extensor mechanism of the knee that includes the quadriceps muscle, the quad tendon, the kneecap (patella) and the patellar tendon.
A tendon is a structure that attaches a muscle to bone. The force of muscle contraction is transmitted through the tendon to move the bone.
It is the extensor mechanism that allows us to straighten our knee or perform a kicking motion. When the quadriceps muscle (thigh muscle) contracts, force is transmitted through the quadriceps tendon, across the patella (kneecap), through the patellar tendon, and the knee is straightened.
Partial quad tendon injuries can happen in association with athletic activities or active lifestyles. These symptoms may cause pain that continues to worsen over the kneecap and may be misdiagnosed as a kneecap problem.
An incomplete injury to the quadriceps tendon may be described as tendinitis, tendinosis, or minimal tearing of the quadriceps. The main thing is to differentiating this is whether or not the tendon is completely torn away from the kneecap.
Complete quadriceps tendon tears are unusual injuries. They most often occur in people over the age of 40, and often in people who have systemic medical conditions that can cause weakening of the tendon.
The quadriceps tendon ruptures generally occurs during an eccentric contraction where the quadriceps muscle is contracting, but the knee is being straightened out. When this happens, the sudden, opposing forces can be bigger then the strength of the quadriceps tendon.
Symptoms and Diagnosis
If the tendon is completely ruptured, you will be unable to straighten the knee without help and you will be unable to perform a straight leg raise. Our Palmdale Physical Therapist say that most individuals with a quadricep tendon rupture will have a swelling of the knee and your doctor will be able to feel the torn tendon just above the kneecap.
Visually, our Palmdale Physical Therapist say that if the swelling is not too severe, you can often see a divot or gap where the tear in the tendon is located.
X-rays can assist your doctor in figuring out if the kneecap was damaged. While an MRI is usually not always needed, your doctor may order the test to evaluate for other damage within the knee joint.
Smaller tears of the quadriceps tendon can typically be managed with non-surgical treatments. These treatments may include the use of a knee brace or immobilizer, ice application, anti-inflammatory medications, physical therapy, and rest from athletic activities.7
Physical therapy can be especially beneficial by strengthening the quadriceps and surrounding muscles, and using other modalities to stimulate healing of the tendon.
Complete tears of the quadriceps tendon require surgical intervention to regain strength in the extremity. Surgery is usually done within a few weeks of the injury, as some reports have displayed that delayed treatment may lead to less successful results.
Surgery is performed to suture the torn tendon back to its attachment on the patella (kneecap). In order to successfully complete this, your surgeon will use a drill to make holes (tunnels) in the patella, and then loop sutures through these tunnels to pull the tendon to the bone.
Following surgery, a handful of surgeons use a brace to protect the repair. Patients may use crutches, although weight can be placed on the leg as long as the knee is kept straight.
A high percentage of surgeons allow early range of motion exercises, but this should be done under the supervision of a physical therapist