Quadriceps tendinopathy

Overview

what it is and why it matters

Front view of the knee showing the femur, tibia, patella, cruciate and collateral ligaments, and the medial and lateral menisci. — **Knee anatomy.** The knee is the meeting point of the thigh bone (femur), shin bone (tibia), and kneecap (patella). Four ligaments hold it together — the ACL and PCL inside the joint and the MCL and LCL on the sides — and two C-shaped menisci cushion the joint surfaces.

Quadriceps tendinopathy is pain and degeneration at the quadriceps tendon — the conjoined tendon of the four quadriceps muscles attaching to the superior pole of the patella. Less common than patellar tendinopathy, it tends to affect older athletes and recreational exercisers. Risk factors include obesity, metabolic disorders (diabetes, gout), and fluoroquinolone antibiotic use.

Diagnosis

exam first, imaging second

Superior patellar pole tenderness reproduced by pressing at the top of the kneecap. Resisted knee extension reproduces pain. Ultrasound and MRI show intratendinous signal change and thickening at the quadriceps tendon insertion.

Treatment Path

how care progresses at OSI

Load management

Same principles as patellar tendinopathy — progressive loading with careful monitoring.

Heavy slow resistance training

Eccentric and isometric exercises are the foundation of tendinopathy rehabilitation.

PRP injection

Guided injection into degenerated tendon tissue.

ESWT
Non-invasive option for refractory cases.

Surgical Options at OSI

if non-operative care isn't enough

Refractory cases after 6–12 months of structured rehabilitation and biologic treatments.

Overview

Diagnosis

Treatment Path

Load management

Heavy slow resistance training

PRP injection

ESWT

Surgical Options at OSI

Providers Who Treat Quadriceps Tendinopathy

Michael S. Vrana, M.D.

David B. Templin, M.D.

Trent Twitero, M.D.

Further Reading

Find your surgeon

Find your location