Quadriceps Tendon Tear

What is a quadriceps tendon tear?

A quadriceps tendon tear (quadriceps tendon rupture) is a rare but serious injury that makes it difficult for your knee to work properly. Your quads are a group of muscles at the front of your thighs, and your quadriceps tendon connects those muscles to your knee joint. Together, the quadriceps muscles and tendon help you straighten your knee.

People who tear their quadriceps tendon typically require surgery to repair their torn muscle and restore knee function so they can stay active.

What are the types of quadriceps tendon tears?

There are two main types of quadriceps tendon tears:

• Partial tear: Your tendon has stretched but not fully torn.
• Complete tear: Your tissue splits into two pieces, and your muscle is no longer attached to your kneecap.

Who gets quadriceps tendon tears?

Anyone can experience a torn quadriceps tendon. It most often affects people assigned male at birth (AMAB) over age 40.

Athletes and adults aged 50 to 60 who are physically active are more likely than others to experience this type of injury. Certain activities and related sports may increase your risk, including:

• Jumping.
• Kicking.
• Running.
• Stretching.

How common are quadriceps tendon tears?

Quadriceps tendon tears aren’t common. They occur in about 1 in 100,000 people.

What causes a quadriceps tendon tear?

Quadriceps tendon tears typically occur when your knee bends under a heavy load. For instance, if you twist your knee or land awkwardly after jumping, the force is too much for your tendon.

You can also tear your quadriceps tendon when you fall or try to prevent a fall. Direct force (trauma or a cut) to the front of the knee can cause a tear, as well.

What other factors may increase your risk of quadriceps tendon tear?

In some cases, quadriceps tendon tears occur in people with joint or tendon weakness. This may be due to underlying health conditions, such as:

• Chronic kidney (renal) disease (CKD).
• Diabetes mellitus.
• Gout.
• Leukemia.
• Obesity.
• Rheumatoid arthritis (RA).
• Secondary hyperparathyroidism.
• Systemic lupus erythematosus (SLE).
• Tendinitis.

Other risk factors associated with muscle and tendon weakness include:

• Certain medications, including corticosteroids and fluoroquinolones (special antibiotic).
• Knee surgery and immobilization.
• Previous knee injury.

What does a quad tendon tear feel like?

When you rupture your quadriceps tendon, you may feel a popping or tearing sensation in the front of your thigh. If the tear is complete, you can’t straighten your knee.

You may have difficulty walking if your knee buckles or gives out. You also can’t perform a straight leg raise. Other symptoms include:

• Bruising.
• Muscle cramp in quads.
• Pain.
• Small gap (indentation) in your kneecap.
• Swelling.
• Tenderness.

What other complications are associated with quadriceps tendon tears?

Prompt diagnosis is important for effective treatment of a quadriceps tendon tear. Rarely, long-term complications include:

• Decreased mobility.
• Inability to walk.
• Leg pain or weakness.

How is a quadriceps tendon tear diagnosed?

A healthcare provider diagnoses a quadriceps tendon rupture with a physical exam. They may check to see if you can extend or straighten your knee.

The provider may recommend additional tests to determine the exact location and severity of your injury, including:

• MRI (magnetic resonance imaging).
• X-ray.

Can a quadriceps tear heal on its own?

Partial quadriceps tears may heal on their own with proper treatment. Complete tendon tears typically require surgery. You also receive rehabilitation and physical therapy to strengthen your tendon and help it work properly again.

How do you treat a torn quadriceps tendon?

Treatment for a torn quadriceps tendon depends on the severity of the tear, your age and activity level. You may receive nonsurgical treatment, surgery or both.

Nonsurgical treatment may include:

• RICE (rest, ice, compression and elevation) to reduce swelling or pain.
• Nonsteroidal anti-inflammatory medication (NSAIDs), such as ibuprofen and naproxen, to ease swelling or pain.
• Knee brace or immobilization to rest and stabilize your affected tendon.
• Physical therapy to restore strength, flexibility and function.

If you need surgery, your surgeon uses a wire, cables or sutures (stitches) to repair your tendon and hold your kneecap in place. People who require surgery have better results if a surgeon does the repair soon after the injury.

Early repair can prevent scars from developing. It may also keep your tendon from growing tighter and shorter, which can limit your mobility. Your provider may recommend additional procedures if more than a month has passed after your injury.

How can I reduce my risk of developing a quadriceps tendon tear?

Muscle tightness, weakness or fatigue (tiredness) can increase your risk of developing a quadriceps tendon tear. To help reduce your chance of injury:

• Maintain your overall physical fitness.
• Warm up and stretch before exercise. Take time to recover after.
• Wear proper safety equipment when playing sports.

Follow your healthcare provider’s recommendations for any medical conditions you have that may lead to tendon or muscle weakness. Your provider can recommend ways to help you prevent injury and avoid complications.

How long does a torn quadriceps tendon take to heal?

The length of time it takes for a torn quadriceps tendon to heal depends on the type of tear and its severity. A partial tear can take several months to heal. A complete quadriceps tendon tear generally takes four to six months to heal. Many people find that it takes up to a year to reach their activity goals.

What’s the outlook for quadriceps tendon tear?

People who receive the right treatment for quadriceps tendon tears typically have good outcomes. Most people regain full range of motion and strength.

Rehabilitation is important to help strengthen your tendon and improve mobility so you can return to the activities you enjoy. Pain and swelling decrease over time while your quadriceps function improves.

If you participate in competitive sports, talk to your healthcare provider about when you can return to play after a quadriceps tendon tear. They can help you find ways to prevent reinjury and avoid complications.

When should I seek care for a quadriceps tendon tear?

Contact your healthcare provider if you experience intense pain, swelling or numbness in your leg. If you’re injured during a sports activity, don’t try to “play through your pain.” Seek immediate care to prevent further injury and avoid complications.

How is a quadriceps tendon strain different from a quadriceps tendon tear?

Quadriceps muscles are skeletal muscles made up of bundles of fibers. Muscle strain occurs when your body pulls these fibers and they stretch farther than they should. Tears happen when the stretched fibers begin to break.

A note from Cleveland Clinic

A quadriceps tendon tear is a rare but serious injury that often requires surgical treatment. It can be an especially frustrating condition if you enjoy an active lifestyle or playing sports. Prompt diagnosis and effective treatment can help you avoid being sidelined for longer than necessary. Talk to your healthcare provider about ways to reduce your risk of injury so you can stay active.