Member Case Study: Quadriceps Tendonitis

author : AMSSM

comments : 1

I am dealing with quadriceps tendonitis (QT) evidently brought on by my running, and am also recovering from meniscus surgery. I would think swimming would be good, but it seems to aggravate it some?

Member Question from GaryRM
I am dealing with quadriceps tendonitis (QT) evidently brought on by my running, and am also recovering from meniscus surgery. I have a couple of stretching exercises from a PT but was wondering what the best treatment is for QT. I would think swimming would be good, but it seems to aggravate it some. Also, can QT cause swelling in the knee area?

Answer from Benjamin A. Hasan, MD

Member AMSSM

Quadriceps tendonitis is a well known overuse injury among runners and athletes in running sports. The running community understands that fast pace running, speed work, and running downhill can be notorious for causing quadriceps tendonitis. The main points of recovery are to remain active while avoiding these specific known triggers. The amount of rehabilitation you do depends on how well you are tolerating your routine.

The second part of your question deals with recovery from meniscus surgery. As there continue to be more older runners in America and more athletes with meniscus tears at an earlier age, more of us will be returning to running following arthroscopic surgery. If your physician has given his or her clearance for specific activities, including running, the important points are to choose activities that do not aggravate the symptoms. If swimming does aggravate it early on, try other types of cross-training for a few weeks and come back to it. Swimming should become tolerated quite quickly. Any activity can cause swelling after surgery if done too intensely too soon.

Your two questions come together when we describe general knee rehabilitation exercises taught by therapists, athletic trainers, and physicians. The science of the complex mechanical balances in the knee is becoming better understood in the sports science community. The need for quadriceps muscle strengthening (cycling, knee bends to 90 degrees, swimming kicks, lateral sliding exercises), working on improving the knee range-of-motion with stretches, and improving the body's sense of proprioception are all important elements of your rehabilitation.

Proprioception is the body's sense of where it is in space. Knee proprioception is subconscious (we do not have to ask our bodies to do it). The proprioception goal is reached by working on coordinating the main nerve in the thigh with the thigh muscles during strengthening. Adding balancing challenges is a common method of improving proprioception. Examples are knee bends on one leg on the floor, a pillow, or mini trampoline. Complex routines can be put together in a therapy center. Simple and effective proprioception exercises can be taught for home use, including activities mentioned above.

Do less if you are hurting. Use ice on a sore knee. Advance activities gradually when you tolerate your initial intensity.

Good luck in all of your training!

Benjamin A. Hasan, MD
Director of Sports Medicine
UIC/Advocate Illinois Masonic Family Medicine Residency
4600 N. Ravenswood
Chicago, IL
60640
 

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date: February 11, 2009