Quadriceps Tendonitis

The quadriceps tendon is part of the extensor mechanism of the knee. This mechanism consists of the quadriceps muscle group, quadriceps tendon, patella, patellar retinaculum, patellar ligament and various soft tissue in the area. In the United States, knee injuries occur in more than 3 million people every year. Chronic anterior knee pain is common and often is associated with patellar malalignment (an imbalance of patellar posture) and abnormal patellar tracking (abnormal movement of the patella when flexing the knee, commonly associated with anterior knee pain and osteoarthritis).

Quadriceps Tendonitis affects the patellar tendon just above the kneecap area. This condition is the painful degeneration of the inside of the quadriceps tendon above the kneecap. A person experiencing quadriceps tendonitis will have particular pain straightening the lower leg, or decelerating when walking. Occasionally other conditions may be associated with quadriceps tendonitis including diabetes, gout, and para-hypothyroidism. Other conditions which can be a cause of anterior knee pain are commonly confused with quadriceps tendonitis. These conditions include patellar tendonitis, synovial plicae, chondromalacia, patello-femoral subluxation and hyper-pressure, fat pad impingement or Hoffa's syndrome and patello-femoral arthritis.

Treatment

When treating tendonitis of the quadricep, rest the area (meaning do NOT workout this area other than stretching), apply cold compression for 10-20 minutes at a time for at least 3 times a day. Do this to the injured area for the first day up to 3 days. Blood Flow Stimulation Therapy may be used after the acute swelling is improved. Cold compression therapy will reduce initial inflammation and swelling and Blood Flow Stimulation Therapy increases blood flow through the area to speed the healing process. This can be further helped by the use of ultrasound applications over the affected area, as it reduces swelling quickly and increases blood flow to the area, helping the tendon heal more quickly.

If the strain is minor, the body may be able to heal the tendon fibers normally. Unfortunately, this is not the usual result because the injured tendon is being used instead of rested. Because of the stress on the tendon, the body heals the injured quadricep tendon fibers by binding them together with fibrotic adhesions or scar tissue. This is done in an attempt to prevent further damage to the injured area. It is a normal protective response of the body.

To prevent this the patient should use ultrasound therapy on the area up to three times daily. Ultrasonic energy will naturally "work" the tendon, increasing its flexibly while softening and breaking down scar tissue - which is not something you want in your tendon. Scar tissue is inflexible (non-elastic), and can quickly lead to re-injury of the tendon later down the road.

The trick to any tendon injury is getting it to heal with minimal scar tissue formation and with as much realignment of tendon fibers as possible - something Blood Flow Stimulation Therapy and Therapeutic Ultrasound are great at! Even with optimum healing there is always less elasticity in a previously injured tendon. The trick is to make sure you heal this the best you can, that way your chance of re-injury down the road is much lower than average - which is well over 50%. Otherwise, persistent symptoms will occur, eventually leading to corrective surgery.

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