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What Can Cause Quadriceps Tendon Rupture and What are its Symptoms?

What is Quadriceps Tendon Rupture1?

The quadriceps tendon may rupture or tear during sports activities, especially in young adults. It can also result from a forceful impact to the knee like jumping from heights.

Quadriceps Tendon Rupture

What is a Tendon?

The fibrous tissue that connects the muscles to the bone of the human body is called a tendon. The amount of pressure applied to a big size tendon is usually 5 times more than the body weight of a person.

What is Tendon Rupture2?

A rupture may happen when the tendon opens and burst. The tendon can even snap in dire occasions.

A rupture can cause extreme pain in some cases and may result in permanent disability when not attended or treated for a long time. Each type of rupture has its unique indications and may require medication or even surgery in some situations.

What are Quadriceps or Quads?

Quadriceps combines four muscles. These are rectus femoris, vastus medialis, vastus lateralis and the vastus intermedius. These muscles are located above the kneecap (patella), which forms the patellar tendon. Quadriceps or Quads are particularly responsible in extending the lower limbs while walking, running, and jumping.

What is a Unilateral Quadriceps Tendon Rupture (QTR)?

Unilateral quadriceps tendon rupture (QTR) can be defined as the snap or rupture, which is seen in any of the direction on the fault. Quadriceps Tendon Rupture (QTR) are mostly unilateral.

What is Bilateral Quadriceps Tendon Rupture (QTR)?

When ruptures are noticed in both parts of the faults, it is called a bilateral quadriceps tendon rupture (QTR)3. This syndrome is related to other systemic diseases. However, the syndrome can be noticed in healthy people as well with no predisposing ailment. This type of ruptures is seen very less in people than the other types of knee injuries.

Quadriceps Muscles or Quad Muscles

The quad muscles comprises of 4 distinct muscles:

  1. Rectus femoris.
  2. Vastus medialis.
  3. Vastus intermedius.
  4. Vastus lateralis.

The four quadriceps or quad muscles join above the patella or the kneecap region and form a very strong tendon known as the quad tendon. The quad tendon joins into the superior portion of the patella. The quadriceps muscles or quad muscles help in straightening the knee joint, maintaining the general strength of the limbs during walking/running, and in maintaining the balance of the body along with the hamstrings. The common manner in which this injury occurs is falling from a drop as this causes undue burden on the quad tendon resulting in its tear. Usually these quad ruptures happen at a spot around 0-2 cm on the top side of the patella. These degenerative changes can be a result of the natural ageing process; however, individuals having other illnesses such as obesity, diabetes or history of earlier steroid doses are more prone to develop this injury.

Quadriceps Tendon Rupture

What Can Cause Quadriceps Tendon Rupture (QTR)

A person can develop syndrome of quadriceps tendon rupture (QTR) due to the rapid contraction of the quadriceps muscle. The foot usually gets planted and the knees experienced to be flexed during quadriceps tendon rupture (QTR). Such injury may occur to a person if he falls by any chance. Direct blows, certain iatrogenic causes and lacerations can cause quadriceps tendon rupture (QTR) in a person.

  • This happens to people of older age who have reduced flow of blood in their quadriceps tendon.
  • It even occurs due to the quadriceps contraction along with eccentric loading (the stretching of the muscle.)

The causes of quadriceps tendon rupture (QTR) are:

  • Trauma or injury usually involving quadriceps muscle contraction in quick succession.
  • Direct fall onto a flexed knee.
  • Direct trauma or laceration to the tendon itself.
  • Degenerative changes due to ageing.
  • Individuals having other medical illnesses such as obesity, diabetes, or history of previous steroid injections are more prone to develop this injury.

What are the Signs and Symptoms of Quadriceps Tendon Rupture (QTR)

People with previous ailments due to knee swelling, pain or any other injuries are more affected with quadriceps tendon rupture (QTR). However people with no history of any knee pain are also recorded to be affected by quadriceps tendon rupture (QTR). Yong people who had jumpers knee8 may experience pain above their patella. It is better to ask the patient about their previous ailments from any steroid use, tumor, surgeries or infection.

The general signs and symptoms of quadriceps tendon rupture (QTR) are

  • Inability to bear weight.
  • The knee gives way during movements.
  • Absence of muscle strength when extending the knee against resistance.
  • There may be complete inability to straighten the leg or to perform a straight leg raise in more severe injuries.
  • Swelling above the knee joint.
  • Pain above the knee joint.
  • Bruising may also be present above the knee joint.
  • Audible ‘crack’ or ‘pop’ at the time of injury.
  • Downward movement of the patella can be seen.

Risk Factors for Quadriceps Tendon Rupture (QTR)

Several conditions may increase the risk factors4 of quadriceps tendon rupture (QTR) in a person:

  • Hyperparathyroidism
  • Gout5
  • Chronic renal failure
  • Excessive body weight
  • Leukemia
  • Diabetes mellitus
  • Any sort of infection
  • Rheumatoid arthritis6
  • Any metabolic disease
  • Steroid abuse
  • Immobilization
  • Systemic lupus erythematosus (SLE)7
  • Tumors
  • Jumper’s knee is usually caused by repetitive motion.

Complications in Quadriceps Tendon Rupture (QTR)

A person affected by rupture may experience physical weakness or trouble in motion. The complications can further include skin breakdown, infection from wounds, etc. In dire occasions, rupture can cause misalignment to the patella. It includes patellar tilt, patellar subluxation and patella alta.

The patellofemoral joint may be affected by the inherited misalignment if proper care is not taken during the surgery for restoration of the ailment. Complications in quadriceps tendon rupture (QTR) include:

  • Feebleness of quadriceps muscles.
  • Tendon re-rupture post treatment.
  • Increased healing time, if lately attended
  • Possibility surgery infection, nerve damage, bleeding or even damage of certain tissues after a surgery.


Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:October 5, 2020

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