Quadriceps Tendon Tear
The quadriceps tendon works with the muscles in the front of your thigh — the quadriceps — to straighten your leg.
Although anyone can injure the quadriceps tendon, tears are more common among middle-aged people who play running or jumping sports, or who have sustained an injury such as a sudden fall.
The four quadriceps muscles meet just above the kneecap (patella) to form the quadriceps tendon. Tendons attach muscles to bones. The quadriceps tendon attaches the quadriceps muscles to the patella. The patella is attached to the shinbone (tibia) by its tendon, the patellar tendon. Working together, the quadriceps muscles, quadriceps tendon and patellar tendon straighten the knee.
A complete tear of the quadriceps tendon is a disabling injury. It usually requires surgery to regain full knee function.
Quadriceps tendon tears can be either partial or complete.
Some tears do not completely disrupt the soft tissue. This is similar to a rope stretched so far that some of the fibers are torn, but the rope is still in one piece.
A complete tear will split the soft tissue into two pieces.
When the quadriceps tendon completely tears, the muscle is no longer anchored to the kneecap. Without this attachment, the knee cannot straighten when the quadriceps muscles contract.
Cause & Symptoms
A quadriceps tear often occurs when there is a heavy load on the leg with the foot planted and the knee partially bent. Think of an awkward landing from a jump while playing basketball. The force of the landing is too much for the tendon and it tears.
Tears can also be caused by falls, direct force to the front of the knee, and lacerations (cuts).
A weakened quadriceps tendon is more likely to tear. Several things can lead to tendon weakness.
Inflammation of the quadriceps tendon, called quadriceps tendonitis, weakens the tendon. It may also cause small tears. Quadriceps tendonitis is most common in people who run and participate in sports that involve jumping.
Weakened tendons can also be caused by diseases that disrupt blood supply.
Chronic diseases which may weaken the tendon include:
Chronic renal failure
Conditions associated with renal dialysis
Systemic lupus erythematosus (SLE)
Steroid use. Using corticosteroids has been linked to increased muscle and tendon weakness.
This special type of antibiotic has been associated with quadriceps tendon tears. These are often used to treat urinary tract infections or pneumonia.
When you are off your feet for a prolonged period of time, the muscles and tendons supporting your knees lose strength and flexibility.
When a quadriceps tendon tears, there is often a tearing or popping sensation.
Pain and swelling typically follow. Additional symptoms include:
An indentation at the top of your kneecap where the tendon tore
Your kneecap may sag or droop because the tendon is torn
You are unable to straighten your knee
Difficulty walking due to the knee buckling or giving way
Your doctor will discuss your medical history.
Questions you might be asked include:
Have you had a previous injury to the front of your knee?
Have you ever injured a quadriceps muscle?
Do you have quadriceps tendonitis?
Do you have any medical conditions that might predispose you to a quadriceps injury?
To determine the exact cause of your symptoms, your doctor will test how well you can extend, or straighten, your knee. While this part of the examination can be painful, it is important to identify a quadriceps tendon tear.
To confirm the diagnosis, your doctor may order some imaging tests, such as an X-ray or magnetic resonance imaging (MRI) scan.
The kneecap moves out of place when the quadriceps tendon tears. This is often very obvious on a lateral or “sideways” X-ray view of the knee. Complete tears can often be identified with these X-rays alone.
This scan creates better images of soft tissues like the quadriceps tendon. The MRI can show the amount of tendon torn and the location of the tear. Sometimes, an MRI is required to rule out a different injury that has similar symptoms.
Great Lakes Physical Therapy
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