Quadriceps Tendonitis



The Quadriceps Tendon

The knee is one of the most unique joints in the body. The kneecap is the largest 'sesamoid' a bone wrapped inside a tendon that connects the large muscles on the front of the thigh, the quadriceps muscles to the lower leg bone.

The quadriceps tendon helps us straighten our leg; this part of the knee is like a lever made-up of the quadriceps muscle group, quadriceps tendon, patella, patellar retinaculum, patellar ligament and various soft tissue in the area. The second job of this group of muscles and tendons and ligaments is very important for stabilizing the leg.

Quadriceps tendinitis (also spelled tendonitis) is a painful condition affecting the quadriceps tendon above the patella (kneecap). The quadriceps group of muscle (individually called the vastus lateralis, vastus intermedius, vastus medialis and the overlying rectus femoris) is the largest in the front of the thigh and is very important for stabilizing the leg. The quadriceps tendon connects the quadriceps to the tibia (shins) via the patellar tendon, which surrounds the knee cap itself. The movement of the knee known as the quadriceps mechanism involves the patella (knee cap), the patella tendon, the quadriceps and its tendon. They all work together to extend the leg to straight.

Quadriceps tendonitis can lead to tendinosis if left untreated.

Quadriceps tendonitis is caused by repetitive use of this tendon. This condition is most common in an athlete who is in involved in sports that require lots of jumping such as basketball, volleyball and jogging, or in a sport that requires a lot of stopping and starting. Little tears in the tendon and tendon sheath will present as pain and inflammation if these tears are not allowed to heal with rest.

Quadriceps tendinitis - inflammation of the quadriceps tendon is caused by tiny tears that are not giving the proper rest to heal.

Inflammation in the quadriceps tendon is often due to irritation and/or micro-tearing of tissue fibers. When the fibers tear, they become weaker, inflamed and swollen causing pain and tenderness in the area.

There are 2 types of tendonitis, acute and chronic. Acute quadriceps tendonitis refers to inflammation that comes on suddenly, usually from a tendon strain or overloading it during exercise. Chronic quadriceps tendonitis occurs over time and generally results from long term repetitive use of the quadriceps tendon.

With both types of tendinitis, scar tissue develops on the tendon as the tears begin to heal. This scar tissue mends the tears in an abnormal way leaving the collagen fibers weaker and more prone to further injury. In the case of chronic quadriceps tendinitis, a build up of scar tissue over a long period of time will make the tendon and the entire knee joint more prone to re-injury.

Other conditions which can be a cause of anterior (front) 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.



Symptoms of Quadriceps Tendinitis

If you are suffering from Quadriceps Tendinitis pain in the area at the bottom of the thigh, just above the knee cap. The most noticeable pain is when you move your knee, the more you move the more tenderness develops in the area of the tendon attachment just above the kneecap.

  • Pain when tightening or flexing the quadriceps with a straight leg.
  • Pain when the top of the kneecap is pressed.
  • Irritation or pain when moving from a crouched position to a standing position.
  • Stiffness or tightness in the morning when you get up or the day following any activity or exercise that irritated the area.
  • Tenderness and swelling in or around the quadriceps tendon
  • You may feel a sensation of warmth or burning pain.
Quadriceps Tendinosis  can cause pain at the front of the knee


Causes of Quadriceps Tendinitis

Quadriceps tendonitis is caused by repetitive use of this tendon. This condition is most common in athletes who are involved in sports that require a lot of jumping such as basketball, volleyball and jogging, or in a sport that requires a lot of stopping and starting.

Quadriceps tendinitis can be a sport related injury for runners

Inflammation in the quadriceps tendon is often due to irritation and/or micro-tearing of the collagen fibers. When the fibers tear, they become weaker, inflamed and swollen causing pain and tenderness in the area.

There are 2 types of tendonitis, acute and chronic. Acute quadriceps tendonitis refers to inflammation that comes on suddenly, usually from a tendon strain or overloading it during exercise. Chronic quadriceps tendonitis occurs over time and generally results from long term repetitive use of the quadriceps tendon.

With both types of tendinitis, scar tissue develops on the tendon as the tears begin to heal. This scar tissue mends the tears in an abnormal way leaving the collagen fibers weaker and more prone to further injury. In the case of chronic quadriceps tendinitis, a build up of scar tissue over a long period of time will make the tendon and the entire knee joint more prone to re-injury.

Quadriceps Tendinitis Risk Factors include:

  • Participating in "jumping" sports such as basketball, volleyball and jogging.
  • Having diabetes, gout or para-hypothyroidism.
  • Incorrect footwear, while participating in a sport
  • Age can be a factor because as we grow older our tendons become more brittle and therefore prone to injury.
  • Activities that require sharp, sudden changes of direction or lots of stopping and starting.
  • Mis-alignment of the foot, ankle, and leg including flat feet, leg length differences, tracking abnormalities, etc.



Do You Really Have Quadriceps Tendinitis?

Other conditions which can be a cause of anterior (front) knee pain are commonly confused with quadriceps tendonitis.

Quadriceps Tendinosis - Tendinosis refers to a non-inflammatory, degeneration of the collagen fibers in a tendon. This tissue break down is often caused by repetitive stress on the tendon fibers and the failure for the fibers to heal.

Partial Quadriceps Tendon Tears - Usually seen in people over the age of 40 as the tissue as part of aging degenerates. A sudden trauma to the tendon may cause it to tear or may spontaneously tear with people suffering from diabetes mellitus, gout, systemic lupus erythematosus, rheumatoid arthritis, end-stage renal disease, prolonged systemic steroid use or hyperparathyroidism. Early surgical repair within 27hrs is the key to successful healing of the tendon. (source: National Library of Medicine)

Quadriceps Tendinosis  can cause pain at the front of the knee

Quadriceps Tendon Complete Ruptures - If you are suffering from a complete rupture of the quadriceps tendon you will have a very painful and swollen knee. The rupture has left you unable to walk or you may walk with assistance or holding your leg as straight as possible. You may notice a gap in the tendon just above the kneecap where the muscle and tendon have broken away from the bone. Early surgical repair within 27hrs is the key to successful healing of the tendon. (source: National Library of Medicine)

Synovial Plicae - Weakness in the knee as if it is unstable while walking up or down stairs or slopes. Extension of the knee causes pain, and you may hear a cracking noise when flexing and straightening your knee. At the 12th week of life the synovial plica forms in the knee - as we grow and mature, this tissue can become entangled within the knee and is unable to dissolve and remains through to adulthood. It is estimated that 50% of the population has this condition and it is common for this condition to be over-looked by doctors. (source: National Library of Medicine)

Calcific Tendinitis - due to a chemical reaction in the body. After a soft tissue injury the tissue is healing but instead of healthy tissue, it creates calcium in the tendon. If you are suffering calcific tendinitis of the quadriceps tendon, you may have pain and stiffness that may last for a few weeks to two months and suddenly disappear. If calcific tendinitis returns a number of times (chronic) you may notice your pain linger for a few months to years.

Chondromalacia Patella - Causes a dull, aching pain in the front of your knee. There is damage or softening of the cartilage on the underside of the knee cap. Pain while walking up or down stairs, kneeling or squatting or after sitting for long periods of time with your knee bent.

Hoffa's syndrome or fat pad impingement - Pain, inflammation, and swelling at the front of the knee cap and along the sides of the patellar tendon. Increased pain when standing for long periods of time, squatting or using stairs and or pain when you extended you knee. Hoffa's syndrome is caused by the pad either suffering a contusion or an injury, resulting in damage and swelling. This can lead to the Hoffa's pad becoming trapped/pinched between the femur and the patella every time the leg is extended.

Patellofemoral Subluxation - Pain on the sides and around the knee cap. The kneecap slides up and down in a groove on the end of the thigh bone (trochlear groove). In some people the kneecap is pulled toward the outside of the knee and the kneecap does not slide in its groove. This condition normally affect adolescents and younger children.

Patellofemoral Arthritis - Causes pain in the front of your knee and can make it difficult to kneel or climb stairs. The kneecap slides up and down in a groove on the end of the thigh bone (trochlear groove). Patellofemoral arthritis occurs when the cartilage (along the trochlear groove and on the underside of the patella) wears down and becomes inflamed.

knee impingement hoffas syndrome

Conditions that may be associated with quadriceps tendonitis include diabetes, hyper-pressure, gout, and para-hypothyroidism.



Quadriceps Tendonitis Diagnosis

A visit to your doctor is really the best and only way for a proper diagnosis of any type of knee pain. To help your doctor achieve a proper diagnosis, he/she will begin with a medical history about you, your current condition and symptoms. He/she will inquire about the intensity of your present pain, the duration of your symptoms and the limitations you are experiencing. Details about what instigated the problem, when it started, and whether or not you have ever had treatments for this or a similar condition in the past, are very helpful in assessing your injury.

Diagnostic testing may be ordered help discover your source of knee pain. Often used to rule out other conditions.

X-rays will provide a two-dimensional image of the overall structure of your knee. They are helpful in identifying knee instability, abnormal bone shapes (bone spurs or bone cysts, fractures, wear and tear on the joints).

MRIs (magnetic resonance imaging) will provide more detailed information and will help to evaluate the soft tissues in and around your knee (muscles, tendons, ligaments, and other connective tissues). It can identify ligament or tendon damage, and can help to determine the extent of your injury, the displacement and degree of your tear or inflammation, as well as other associated knee conditions.



Quadricep Tendonitis Home Conservative Treatment Options


Step 1 - Reduce Pain and Swelling with Cold Compression

The first step for conservative treatment of tendonitis in the knee is to reduce the swelling to "open up" the area for more blood flow. Anyone in the health-care business knows that your blood supplies the oxygen and much needed nutrients required to heal knee tendonitis injuries. This is why for years, doctors, trainers, and other medical professionals have recommended RICE (Rest, Ice, Compression, Elevation) to treat the pain and swelling of fresh injuries, chronic pain, and after any re-injury.

This is important because once blood vessels are blocked or damaged, they can no longer carry oxygenated blood to your damaged tendon and tissues begin to break-down. Without cold compression, tissues break down further because they can't get the oxygen they need to survive. By limiting the amount of damage done to your tendons, you also limit the amount of healing that needs to occur. This is a very important step to heal acute or chronic tendon injuries faster and with less pain.


Use a Cold Compress or Ice Pack:

  • 24 to 72 hours after your initial injury or when you first notice pain and swelling in your knee to stop tissue damage at the microscopic level, relieve pain, and decrease swelling.
  • After exercise, workouts or activity of any kind to prevent re-injury of your knee.
  • Before and after surgery during rehabilitation to control pre and post-surgery pain and swelling.
  • Anytime you feel your knee is painful or you're having a flare-up of an old patellar tendon injury.
  • Anytime you have swelling, sharp throbbing pain or inflammation in your knee.
  • Any other situation where you need to draw the pain and inflammation out of your knee.

Step 2 - Improve Circulation, Soften Scar Tissue & Prevent Re-Injury with a T•Shellz Wrap®

After the inflammation in your knee has been reduced, providing extra blood flow and strengthening the tissue around your knee is recommended.

healing your patella tendonitis
  • When treating any soft tissue injury, an effective treatment will increase blood flow to the injury while the joint is immobile.
  • This increase in blood flow will improve the efficiency of the body's own ability to heal itself.

What Else Makes the T•Shellz Wrap® So Special?

We believe the T•Shellz Wrap® to be one of the most effective treatments to stimulate blood flow to tissue in the treatment area.

We can promise that you will receive a product that is designed to be safe and does what it is supposed to do...quickly relieve pain and aid in the recovery from tendon, muscle and other soft tissue injuries.

The unit plugs into a standard wall outlet to get its power. The nice thing about the power supply is that the same unit can be used in North America and overseas as well. It has the capability to operate between 110v and 230v. It has a special signal controller that can be set for 3 different power levels of application (3=High, 2=Medium, 1=Low). The cord is long so you can sit or lie comfortably and watch TV, read or surf the net while you're using it.

We recommend 5 to 10 minute treatments to start; the safety shutoff controller is set to max 30 minutes in duration. The device can be worn over clothing and allows you to use the device at work, at home, or really anywhere you have access to an electrical outlet.



A Recap of the Benefits of the Knee T•Shellz Wrap®..

  • Our Knee T•Shellz Wraps® can fit ANYWHERE on the knee - side, back and front.
  • It can be used before activity or exercise to warm up tissue in the knee to reduce the risk of further injury
  • knee T•Shellz Wrap
  • FDA Registered medical device for use in home or clinics - very high quality
  • Temporarily increases flexibility and length of soft tissue (reducing the re-injury factor)
  • It soothes pain and whisks away toxins
  • Carbon fiber Energy Pad is strong, lightweight, and flexible - contours very easily
  • A boost in blood flow helps maximize the body's ability to recover from soft tissue damage. This can be beneficial in saving time and money when associated with doctor or physical therapist visits
  • A boost in blood flow will maximize the body's ability to recover quickly. This can be beneficial in post-surgery rehabilitation, getting you back to work faster. Do not use until at least 6 weeks after surgery, and only after approval from your doctor.
healing your patella tendonitis

When Should I Use My T•Shellz Wrap® During the Day?

The most common question we receive from individuals prior to purchasing is - how many times a day should I be using my wrap and when should I be using them? While treatment plans will differ for each individual and their specific injury, there are general guidelines that should be adhered to.

  • Use a Cold Compress or Ice Pack when you are experiencing inflammation (usually after exertion or movement of the injury area).

The T•Shellz Wrap® would then be used:

  • Right after rising from bed in the morning (as this is when your knee is often stiff)
  • Prior to going to bed at night (to relax the area and allow for better sleep)
  • Before you know you will be using your injured joint (going to work, driving, typing, etc).

Use a Circulatory Boost Knee T•Shellz Wrap®:

  • After swelling and inflammation have been reduced with cold compression.
  • Before exercise or workouts to warm up your knee to reduce your risk of re-injury.
  • Before and after surgery during rehabilitation to warm up soft tissue in your knee before physio, exercising or stretching.
  • Anytime you feel the tissue in your knee has stiffened up, is tight and your mobility is reduced causing you more pain.
  • Any other situation where you need to increase blood flow to your knee to relax tissue in the treatment area, relieve pain, prevent re-injury and enhance flexibility of your tissue.
healing your patella tendonitis

Stage 3 - In Between Treatments With T•Shellz Wrap®, Apply Our New Fast Acting Pain Relief Cream Called ARNICA INFUSION

Dealing with aches and pains affecting the foot, ankle, leg, knee, hamstring, hip, back, arm, shoulder, elbow, wrist, or hand? If so, then applying the Arnica Infusion to any of these targeted areas will bring about fast relief from the pain and sore tissues. Simply apply a small amount of cream to the body and moments later, you will experience a soothing and comforting sensation over the area.

Arnica Infusion is specially designed to relieve pain due to sore muscles and joints associated with arthritis, backaches, sprains, strains, and bruises. No matter if you are dealing with an acute injury, chronic pain, or a general "flare-up" - you will experience fast relief from pain and inflammation.

mendmeshop arnica pain relief cream

This is a product that many of our current MendMeShop customers asked us to develop. So we focused our time and resources over the past few years and came up, with we believe, will be one of more effective, fast acting, topical pain relief creams on the market.

You are likely familiar with some of the standard topical agents on the market as most of our customers use them. The are mass marketed and even found in most department stores now.

Well, we are here to say that Arnica Infusion goes many steps beyond what they offer.

Made in the USA at an FDA registered manufacturing facility, you can be assured that Arnica Infusion is both safe and effective. We only source top grade ingredients while implementing strict quality control checks during every step of the production process. Expect the same high quality that MendMeShop customers have been accustomed to since we started the company in 2005.

The "Cool Blue" formula is the perfect balance between the smooth application of a cream and the effective absorbing factor of a gel. It is not too thick and not too thin - just the right texture. Best of all, it feels very nice on the skin!

Each application of Arnica Infusion feels so comforting and soothing, we are certain it will become an item you will not want to live without.


Arnica Infusion Ingredients

The Arnica Infusion formula is based on a combination of scientific research and the use of high quality ingredients. The properties within the formula were chosen for their pain relief, anti-inflammatory, and soothing qualities.

The acting ingredients within the formula include ones many of us are familiar with; along with ones that have not received a lot of publicity (only in research circles). Extensive testing resulted in a blending of ingredients that provides the most synergistic of benefits.

The notable ingredients in the Arnica Infusion formula include:

  • Arnica - powerful anti-inflammatory, speeds recovery, enhances circulation
  • Menthol - provides deep penetrating pain relief with a nice cooling sensation
  • Vitamin B6 - promotes normal nerve function
  • MSM - supports healthy connective tissues, anti-inflammatory
  • Ilex Leaf Extract - increases circulation, skin conditioner
  • Vitamin E - anti-inflammatory, enhances circulation, hydrates the skin
  • Aloe - anti-inflammatory properties, soothes the skin
  • Tea Tree - enhances penetration of ingredients

Extensive quality control procedures during the manufacturing process ensure the ingredients and final product are both safe and effective. We would not stake our reputation on anything but the best.

When Do I Apply the Arnica Infusion?

While At Work

Apply Arnica Infusion at work to help reduce acute discomfort associated with overuse of muscles and joints. No matter if you are in a physical demanding job or work within an office environment, you will be placing stress on different parts of the body and aches and pains will result.

Before Or After Work, Sports, & Activity

If you suffer from a sprained ligament, pulled muscle, strained tendon, or even bruising - apply Arnica Infusion for quick relief of the pain.

Chronic Pain Suffering

Application of Arnica Infusion can be done up to a maximum of 4 times per day on a consistent basis to help bring about relief from various pains and aches.

In-between Treatments With the T•Shellz Wraps®

Follow up your T•Shellz and Cold treatments with an application of Arnica Infusion. Combine the pain relieving benefits of Arnica Infusion along with the therapeutic benefits of the wraps to make your recovery go much more smoothly.

Do not apply Arnica Infusion within a 2 hour timespan before a T•Shellz Wrap® treatment.

Whether you decide to use the Arnica Infusion in conjunction with the T-Shell and other treatments - or if you decide to use the cream as a stand-alone product - you will not be disappointed with the results. We guarantee it.

Conservative Treatment Tools Our Clients Have Used to Help
Limit Damage & Boost The Body's Soft Tissue Repair Process at Home:

  • A Cold Compress or Ice Pack to reduce inflammation wherever there is pain and/or swelling (as soon as possible).
  • A TShellz Wrap to increase blood-flow to the treatment area (Circulatory Boost).
  • MendMeShop Arnica Pain Cream for temporary relief of pain due to sore muscles and joints.
  • An Exercise & Stretching Plan to prevent muscle atrophy and shortened tendons in the leg. A proper plan will increase elasticity and strengthen the muscles and tendons in the problematic joint area as well as tissues in the surrounding joints.

Conservative treatment tools just like these have been used successfully by thousands of soft tissue injury sufferers - just like you.




T•Shellz Wrap® = Enhanced Blood Flow in the Treatment Area

 

We believe the use of T•Shellz Wraps® for boosting blood flow to soft tissue in the area of application is one of the most under-utilized home treatment options available on the market today. We have client after client that have tried many options out there and have been amazed at how effective and fast the TShellz Wrap treatment can relieve pain and increase blood flow in the treatment area.

With regular use of the TShellz Wrap:

  • Your pain will be reduced*.
  • Due to increased blood flow, soft tissue in the treatment area will be expected to recover at an accelerated rate with reduced potential for re-injury*.
  • Tissue in the treated area should experience a larger range of motion and increased extensibility of collagen tissue* due to the heat effect on soft tissue. This should translate into a reduced rate of re-injury occurrence as soft tissue is known to lengthen and become more flexible when exposed to warm temperature. (*Chapter 9 of "Therapeutic Heat and Cold", 4th edition. (amazon.com link - Ed. Justus F. Lehmann, M.D., Williams, and Wilkin)

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The Key Points To Keep in Mind When Treating Your Injury

Make Sure That Complete Healing is Your #1 Goal

We all know that if the injury was healed, the pain would go away but what about the opposite situation? If the pain is gone, does that mean the injury is better? Unfortunately, this is not always true.

Too many people only focus on suppressing pain symptoms while providing less attention to the true healing aspects of the body. Experiencing less pain, while obviously a good short-term goal, does not equate to underlying healing. Scar tissue can remain for months after one gets to a point of being relatively pain-free. However, as long the weak and brittle scar tissue remains, you are susceptible to re-injury or re-aggravation. Certain motions or movements can cause the weaker tissue to easily tear - resulting in some reversal of the recovery up until that point.

This is why we recommend for people to continue with their doctor or therapist recommended exercises and to continue with mild treatments of the T•Shellz Wrap® for a period of time - to better ensure complete recovery.

Ongoing treatments to enhance circulation are intended to soothe, relax and promote healing of damaged soft tissue in the application area. T•Shellz treatment also results in the ability of soft tissue to extend further due to the effect of heat on soft tissue. The more extensible your tissues are, the less likely they are to strain or sprain.

Resting The Area of Your Injury Will Help, But Only Temporarily

People tell us all the time, "I was told that if I stay off my feet for a few weeks, my pain will disappear for good."

The truth is, tendonitis pain is usually a culmination of numerous factors, such as repetitive stress, poor posture, acute injuries, and overcompensation issues resulting from other muscle and soft tissue ailments.

It may take weeks or months for these pain triggers to surface. When they , however, merely resting will solve the underlying issues. You need to utilize actions and options that actually treat the source of the pain and help reverse the damage that has been done.

Resting has a role to play, but it is only one small factor in a recovery plan.



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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!


 
 

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