Quadriceps Tendonitis
(One of Three Type of Knee Tendonitis)

What is it?

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. The major point of pain coming from above the kneecap. Occasionally other conditions may be associated with quadriceps tendonitis including diabetes, gout, 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, expecially avoid the particular activity that produced the condition. Anti-inflammatory medication, ultrasound treatment, regular ice, stretching and physiotherapy are all helpful. An ultrasound application over the affected area, will reduce swelling quickly and increase blood flow to the area - increasing the healing rate of the tendon.

If the strain was minor, their 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, their 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 their body.

To prevent this the patient should apply ultrasound treatment on the area up to three times daily. Ultrasonic energy will naturally "work" the tendon, increasing its flexibily 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 reinjury 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 fibres as possible - something radiant energy and 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 reinjury down the road is much lower than average - which is well over 50%. Otherwise, persistent symptoms will occur, eventually leading to corrective surgery

The most common cause of an tendon inflammation (tenosynovitis or tendonitis) is overuse of the affected tendon. Rest of the affected tendon is all that is required in some cases. Other treatments such as anti-inflammatory drugs or a steroid injection are sometimes needed. Infection of a tendon is an uncommon cause but needs treatment with antibiotics if it occurs.

What is tenosynovitis and tendonitis?

* Tendonitis means inflammation of a tendon. (It is sometimes spelled as tendinitis.)
* Tenosynovitis means inflammation of the sheath that surrounds a tendon (the sheath is called the synovium). Tenosynovitis can be caused by calcium deposits, repeated strain or trauma, high levels of blood cholesterol, rheumatoid arthritis, gout, or gonorrhea.
These two conditions often occur together.

Never use Ultrasound over an area injected with a steroid (ie. cortisone) for at least 30 days.

Never use Ultrasound after surgery until your physician recommends and approves of it.