This blog post contains exercises, stretches and strategies to fix Quadriceps Tendonitis.

In This Blog Post:

• What Is Quadriceps Tendonitis?
• Symptoms
• Causes
• Test
• Exercises To Fix Quadriceps Tendonitis

What is Quadriceps Tendonitis?

Quadriceps Tendonitis is the inflammation of the distal tendon of the Quadriceps muscle group (which includes the Rectus Femoris and Vastus Lateralis/Intermedius/Medialis).

This condition presents as pain above the knee cap.

Symptoms

Common symptoms of Quadriceps Tendonitis involve the following:

Causes

Quadriceps Tendonitis occurs when there is an unaccustomed amount of load that is placed on the Quadriceps tendon.

This may involve: (but not excluded to)

The above can also be influenced by factors such as:

• Age, bodyweight, previous injuries, poor footwear and sub-optimal biomechanics.

Test

Here are a few ways to determine if you have Quadriceps Tendonitis.

Palpation

Instruction:

• Press firmly around the area above the knee.

Quadriceps Stretch/Activation

Instructions:

• Stand up right.
• Bend your knee.
• Hold onto your ankle.
• Pull your ankle towards the back of your hips.
• Whilst holding this position, push your foot into your hand.

Single Leg Squat

Instructions:

• Stand up right.
• Hold onto something for support.
• Stand on the side that is to be tested.
• Go on your tippy-toes.
• Perform a single leg squat.

Get a Scan

An Ultrasound or MRI scan will be able to determine if you have inflammatory findings on the Quadriceps tendon.

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Exercises To Fix quadriceps tendonitis

STEP 1: Reduce Aggravation
STEP 2: Reduce Inflammation
STEP 3: Provide Support
STEP 4: Gentle Movements
STEP 5: Releases
STEP 6: Stretches
STEP 7: Isometric Strengthening Exercises
STEP 8: Open-Chain Exercises
STEP 9: Weight Bearing Exercises
STEP 10: Knee-Dominant Exercises
STEP 11: Advanced Exercises

Step 1: Reduce Aggravation

You may need to temporarily avoid, reduce exposure to or modify positions/movements/activities that aggravate the pain in the Quadriceps tendon.

This might involve altering the intensity of running, deep squats, jumping etc.

If the knee continues to be subject to constant aggravation, this will likely limit the effectiveness of the exercises mentioned in this blog post.

(Keep in mind: The goal is NOT to completely rest the knee as this may promote deconditioning which can lead to a prolonged recovery time.)

Step 2: Reduce Inflammation

A significant amount of inflammation in the knee can make it too painful to perform exercises suggested on this blog post.

Anti-Inflammatory Gel

Apply the anti-inflammatory gel to the area above the knee.

Do this 2-3 times per day.

I prefer products with natural active ingredients like arnica, calendula or hypericum.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

It is recommended that you take a strong anti-inflammatory medication for at least 7-10 days.

(Note: Please consult your primary care provider before taking any new medication.)

Cold Therapy

Apply an ice pack to your knee for at least 10-15 minutes.

Do this 3-5 times per day.

(Note: Do NOT place the ice pack directly onto your skin as this may cause an ice burn.)

Natural Products

Taking turmeric and/or fish oil capsules are natural ways to potentially reduce inflammation in the body.

Step 3: Provide Support

In the early stages of rehabilitation – it is recommended to provide additional support to the knee structures.

Here are few ways to provide support:

a) Knee Brace

Providing an external support such as a knee brace/sleeve/wrap may help take some pressure off the Quadriceps tendon.

b) Taping

Instructions:

• Bend your knee to 90 degrees of flexion.
• Outline the border of the knee cap.
• Starting from the mid thigh region, apply 2x intersecting tape bordering the edge of the knee cap at 30 % stretch towards the bottom of the knee.
• Apply decompression tape horizontally across the patella tendon at 80% stretch.

c) Walking Stick

If you are struggling to walk without aggravating the knee, consider using a walking stick to take some pressure off the injured knee.

Note: Do not become reliant on the walking stick! Use it in the short term only.

Step 4: Keep the knee moving

Following any injury – it is important to keep the injured area moving as much as possible without causing a significant increase in symptoms.

Gentle movements of the injured area can help to:

Here are some simple ways to keep the knee moving:

a) Standing

Instructions:

• Stand up right.
• Hold onto something for balance.
• Slowly Bend/Straighten your knee.
• Make sure that you do not move into any pain.
• Perform 30 repetitions.

b) Supine

Instructions:

• Lie down on your back.
• Bend your knee by sliding your heel towards the back of your hip
• Straighten the knee by sliding your heel back to the starting position.
• Make sure that there is no pain whilst performing this movement.
• Perform 30 repetitions.

c) Walking In Pool/Cycling

These are effective ways to keep the knee moving without placing excessive amounts of pressure to the injured area.

Step 5: Releases

Performing the following release techniques may help to reduce tension in the Quadriceps tendon.

a) Thigh

Instructions:

• Lie facing downwards on the floor.
• Place a foam roller underneath the front of your thigh.
• Apply an appropriate amount of body weight on top of the foam roller.
• Proceed to roll your thigh on top of the foam roller.
• Make sure to cover the entire length of the muscle.
• Continue for 1 minute.

b) Quadriceps Tendon

Instructions:

• Sit down on the floor with a rolled up towel underneath your knee.
• Use your fingers to press into the area above the knee cap.
• Continue for 1 minute.

Step 6: Stretches

Stretching the thigh muscle can help reduce tension in the Quadriceps tendon.

Note: Do not stretch into any pain! If there is a significant amount of pain when performing the stretches, you will need to reduce the amount of pressure being applied. If the pain persists, consider introducing the stretches at a later stage in the rehabilitation.

Quadriceps Stretch

Instructions:

• Stand up right and hold onto something for balance.
• Pull your ankle towards your buttocks.
• Keep your knees in line with each other.
• Tuck your tailbone and drive your hips slightly forward.
• Aim to feel a stretch at the front of your thigh.
• Hold for 30 seconds.

Want more thigh stretches?

See Post: Quadriceps Stretches

Step 7: Isometric strengthening

The following isometric strengthening exercises involve producing a contraction in the Quadriceps muscle/tendon without moving the knee joint.

This type of exercise serves as a good starting pointing when rehabilitating a painful knee injury.

a) Quadriceps Squeeze

Instructions:

• Lie down on the floor.
• Place a rolled up towel underneath your ankle.
• Keep your leg straight.
• Push your knee downwards as hard as you can comfortably tolerate.
• Aim to feel a firm contraction in the Quadriceps muscle and tendon.
• Hold for 5 seconds.
• Repeat 20 times.

b) Straight Leg Raise

Instructions:

• Lie down on the floor.
• Push your knee downwards.
• Keep your knee completely locked straight throughout this exercise.
• Aim to feel a firm contraction in the Quadriceps muscle and tendon.
• Lift your leg slightly.
• Perform 20 repetitions.
• Progression:
  • Add an ankle weight.

Note: It is important that you keep the leg completely locked straight throughout this exercise.

c) Knee Extension Isometric (Sitting)

Instructions:

• Sit down on a high chair so that your feet are dangling in the air.
• Place your other ankle in front of the ankle that is on the same side of the injury.
• Keep the leg that is on top completely still through this exercise.
• Push your injured leg into the top leg as hard as you can without causing any pain.
• Hold for 45 seconds.
• Perform 3 repetitions.
• Repeat this exercise in varying degrees of knee flexion.

d) Knee Extension Isometric (Prone)

Instructions:

• Lie facing downwards on the floor.
• Bend the knee with the injury.
• Place the other ankle in front of the ankle that is on the same side of the injury.
• Keep the leg that is on top completely still through this exercise.
• Push your injured leg into the other leg as hard as you can without causing any pain.
• Hold for 45 seconds.
• Perform 3 repetitions.
• Repeat this exercise in varying degrees of knee flexion.

Step 8: Open-Chain Exercises

The next step is to progressively load the Quadriceps tendon whilst moving the knee.

(Keep in mind – some of you may find that your knee is more sensitive to exercises where the foot is not connected with the floor. If this is the case, consider introducing these exercises at a later phase in your rehabilitation.)

a) Sitting Knee Extension

Instructions:

• Sit down on the chair.
• Straighten the knee.
• Aim to feel a contraction in the Quadriceps muscle/tendon.
• Hold for 5 seconds.
• Perform 20 repetitions.
• Perform 3-5 sets.
• Progression:
  • Place an ankle weight on the ankle.

b) Terminal Knee Extension

Instructions:

• Lie down on the floor.
• Place a rolled up towel underneath your knee.
• Push your knee down onto the rolled up towel.
• Whilst keeping the downward pressure onto the towel, lift your foot off the floor.
• Aim to feel a firm contraction in the thigh muscle.
• Hold for 5 seconds.
• Repeat 20 times.
• Progression:
  • Add an ankle weight.

Step 9: Weight-Bear Exercises

With these exercises – Aim to move through as much range of motion as possible without causing any symptoms.

a) Lean Back Squat

Instructions:

• Hold onto a stationary object that is in front of you.
• Keep your feet shoulder-width apart.
• Keep the knees in line with your toes throughout this exercise.
• Lean backwards so that your entire body weight is relying on your arms.
• Drive your hips backwards as you squat down to a depth without causing any symptoms.
• Most of your body weight should be resting on your heels.
• Perform 20 repetitions.
• Progression:
  • Gradually reduce the amount of support being provided by your arms.
  • Squat deeper
  • Move slower
  • Hold onto an appropriate amount of weight

b) Step Up

Instructions:

• Place your foot onto a step.
• Hold onto a stationary object in front of you.
• For the leg on the step, keep the knee in line with your toes throughout this exercise.
• Step up.
• Make sure that you are driving through your heel.
• Slowly lower yourself back to the starting position.
• Perform 20 repetitions.
• Progression:
  • Use less arm support
  • Use a higher step
  • Move slower
  • Hold onto an appropriate amount of weight

c) Standing Knee Extension (Resistance Band)

Instructions:

• Anchor a resistance band in front of you at knee height.
• Loops the other end of the resistance band around the back of your knee.
• Step backwards to create a firm amount of tension onto the band.
• Hold onto something for balance.
• Raise your other leg in the air.
• Straighten your leg against the resistance of the band.
• Aim to feel a contraction in the thigh muscle.
• Hold for 5 seconds.
• Slowly bend your knee.
• Repeat 20 times.

d) Step Back Lunge

Instructions:

• Hold onto a stationary object that is in front of you for support.
• For the leg at the front, keep the knee in line with your toes throughout this exercise.
• Perform a backwards lunge.
• Make sure to place the majority of your weight onto the heel of the foot that is at the front.
• Lunge as deep as you can comfortably tolerate.
• Perform 10 repetitions.
• Progression:
  • Use less arm support
  • Hold onto an appropriate amount of weight

Step 10: Knee-Dominant Exercises

The exercises in this section tend to place more pressure to the knee region.

Aim to feel a distinct increase in tension in the knee as you perform the following exercises.

a) Wall Lunge

Instructions:

• Place your foot onto a step.
• Have both of your hands supported onto a wall that is in front of you.
• For the leg that is on the step, keep the knee in line with your foot throughout this exercise.
• Lean as much of your body weight onto the forefoot of the leg that is on the step.
• Slowly lunge forwards.
• Allow your knee to move forwards as much as you can comfortably tolerate.
• Aim to feel tension in the front of the knee.
• Provide as much support from your hands as required.
• Perform 20 repetitions.
• Progression:
  • Use less arm support
  • Move the knee more forwards
  • Lean more bodyweight into the leg at the front
  • Hold onto an appropriate amount of weight

b) Knee Forward Squat

Instructions:

• Stand with your back and heels against the wall.
• Keep the feet shoulder-width apart.
• Keep the knees in line with your toes throughout this exercise.
• Slowly bend your knees forwards as you slide down the wall.
• Lean as much of your body weight onto the forefoot.
• Aim to feel tension in the front of the knee.
• Only squat to a depth that you are comfortable with.
• Perform 20 repetitions.
• If required- you can take some weight off your knees by holding onto a table for support.
• Progression:
  • Squat deeper
  • Move slower
  • Hold onto an appropriate amount of weight

c) Toe Tap

Instructions:

• Stand up right.
• Hold onto a stationary object for support.
• Stand on your injured leg.
• For the leg that is on the ground, keep the knee in line with your toes throughout this exercise.
• Using your other foot, slowly reach and gently tap your toe on the ground as far forwards as possible.
  • As you perform this movement, the knee on the floor should move forwards relative to the foot.
• Lean as much of your body weight onto the front part of the foot.
• Aim to feel tension in the front of the knee.
• Return to the starting position.
• Perform 20 repetitions.
• Progression:
  • Reach your foot further in front of you.
  • Move slower
  • Hold onto an appropriate amount of weight.

d) Step Down

Instructions:

• Stand on top of a step.
• Hold onto a hand rail for support.
• For the leg that is on the step, keep the knee in line with your toes throughout this exercise.
• Using your other foot, slowly reach your foot down towards the step below.
• Lean as much of your body weight onto the front part of the foot for the leg that is in contact with the step.
• Aim to feel tension in the front of the knee.
• Only lower the foot to a level that you are comfortable with.
• Return to starting position.
• Perform 20 repetitions.
• Progression:
  • Move slower
  • Hold onto an appropriate amount of weight.
  • Reach foot lower.

Step 11: Advanced exercises

Once the previously mentioned exercises are no longer challenging, consider progressing the exercises by performing the following:

• Bouncing on the spot on both legs for 30 seconds.
• Bouncing on the spot on single leg for 30 seconds.
• Hopping on the spot for 30 seconds.
• Hopping in different directions for 30 seconds.
• Gradual return to Jogging/Running/Sprinting
• Sport-specific movements
• Strengthening in the same position when the knee injury occurred.

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Conclusion

Quadriceps Tendonitis is inflammation of the Quadriceps tendon.

It is caused when there is an unaccustomed amount of stress is placed on the tendon (eg. Jumping, Lunging, Kicking).

The best way to address this knee issue is to progressively load the tendon at the appropriate rate and intensity without significantly aggravating the symptoms.

Follow the exercises and strategies mentioned in this blog post to fix Quadriceps Tendonitis

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Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. Seek guidance from a healthcare professional before starting any exercise and/or implementing any recommendation. For more information: Medical Disclaimer.