The quadriceps muscle group is made up of four large muscles in the front of the thigh. These muscles include the:
These muscles originate in the pelvis and travel down the knee to form the quadriceps or patellar tendon that attach onto the shin bone or tibia. These muscles are primarily responsible for knee extension, but also have a role with hip flexion. The quadriceps are extra important during walking, running, squatting, navigating stairs, and jumping.
Tendinitis is commonly said to be an overuse injury, but it should be looked at more as a “wrong use” injury. Tendon injuries do not happen right away and lie more along a continuum due to the complexity of the tendon anatomy. These injuries can be split into two categories, reactive or degenerative. A reactive tendinitis is more acute due to a sudden increase in training volume or poor form during a new activity. Degenerative tendonitis occurs overtime due to chronic misuse or overloading. The time frame underlying these two categories will help determine the best course of treatment.
Quadriceps tendinitis can commonly be classified as anterior or front knee pain. It is typically due to high stress and repetitive loads on the quadriceps muscle group. There is also a correlation between increased BMI and increased incidence of quadriceps tendinitis.
Click to Learn about Jumper's Knee.
It takes a team to manage quadriceps tendinitis. You will be evaluated by an orthopedic doctor who may order imaging to rule out any underlying pathologies, then you will be sent to work with a rehabilitation team of physical therapists, physical therapist assistants, and athletic trainers.
Physical therapy has been shown to be effective in the conservative treatment and management of quadriceps tendinitis. Progression through physical therapy rehabilitation includes rest, isometric loading, strengthening -- which includes eccentric loading -- and sport/ activity specific exercises. These interventions allow the physical therapist to gradually increase the loads during treatment sessions for the patient to return to their original training and competition level. Strengthening programs are designed to target the
Strengthening these muscles helps to gain proper control of the entire lower extremity kinetic chain. Physical therapy interventions should aim to increase hip extensor strength as well as ankle and knee flexibility for the rehabilitation of quadriceps tendinitis.
Stretching programs targeting the quads and hamstrings used in conjunction with eccentric loading has been shown to improve long-term pain and function. Physical therapy interventions that focus on eccentric loading of the quadriceps while standing on a decline board have shown to be beneficial for descending stairs and indicates a successful outcome throughout the physical therapy program.
Click to Learn the 3 Best Hamstring Stretches.
Studies show that a stiff landing pattern with limited knee flexion at landing and a short landing time is associated with quadriceps tendonitis; therefore, it is suggested the diagnosis be coined “landers knee” due to the eccentric load placed on the quadriceps during landing. Physical therapists will retrain athletes on proper jump-landing techniques in order to promote softer landing mechanics, longer landing periods, and improved ranges of motion through hip flexion, knee flexion, and ankle toe-to-heel landings.
Physical therapy programs aimed at decreasing training loads in conjunction with strengthening exercises involving isometrics and eccentrics for a safe return to sport/ activity have been shown to have successful outcomes for the conservative treatment of quadriceps tendinitis.
Other treatment options to Tendonitis include Stem Cell Therapy and Platelet Rich Plasma Injections. These are non-surgical treatments. Both are growing in popularity but in most situations, these treatment options are not covered by insurance.
JOI Physicians continue to offer online new patient appointments. This is another option to make it more convenient to make new patient appointments with less phone hold times. Follow the link below to select your JOI MD and schedule online.
You can still call 904-JOI-2000 to make new patient JOI Physician Appointments if that is your preference.
To make appointments with JOI Rehab, please call 904-858-7045.