Hip & Thigh

What It Is

Overuse of the front of the knee, from repeated loading, can strain and irritate the quadriceps tendon (King et al., 2019a). In turn, pain, swelling and weakness can develop around the knee. These problems can affect people of all ages, and they are particularly common in people who play running and jumping sports such as volleyball, soccer and running (King et al., 2019a; AAOS, n.d.).

Quadriceps tendinopathy used to be known to medical professionals as quadriceps tendonitis. "Tendonitis" means inflammation of the tendon, whereas "tendinopathy" simply means a problem with the tendon. Research has questioned how much inflammation is involved in this condition, and the debate is still going on (Mosca et al., 2018).

Quadriceps tendinopathy is a common sports injury, and it is often seen in runners and jumpers (AAOS, n.d.). Overuse injuries of this part of the knee are common in both athletes and non-athletes (King et al., 2019a). Tendon problems like this weaken the tendon and can lead to small tears, which increases the risk of a quadriceps tendon tear (AAOS, n.d.).

Biomechanical problems, such as an imbalance in the way you walk or run, foot or knee issues, or problems further up such as the hip or lower back, may contribute to the condition.

Quadriceps Tendinopathy Anatomy

The leg is the lower limb of the body. It supports the body when standing, and allows you to run, walk, jump and perform various other movements.

The upper part of the leg (the thigh) begins at the hip and goes down to the knee. The main bone in this region is the femur (thigh bone), which is the largest bone in the body. The head of the femur forms the ball of the ball-and-socket hip joint, and the lower end of the femur forms the upper part of the knee joint. The quadriceps muscles lie at the front of the thigh. The four quadriceps muscles meet just above the patella (kneecap) to form the quadriceps tendon, which attaches the quadriceps to the patella (AAOS, n.d.). As the muscles work together, they help to straighten the knee (AAOS, n.d.).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Quadriceps Tendinopathy

Quadriceps tendinopathy is first treated without surgery, using rest, ice, a proper warm-up before activity and physical therapy, including stretching and quadriceps strengthening (King et al., 2019b). I can guide you through a stretching and graded strengthening programme for the thigh and tendon, with hands-on work to ease tightness in the quadriceps. See the My Approach tab for how I work.

Rest or Reduce Activity

Based on the severity of the symptoms, rest or a change in activity is often needed (King et al., 2019b). Once the pain has settled, you can slowly return to normal activities, as long as the pain doesn't return. Try reducing the frequency or intensity of the activity.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Injections: for severe cases that do not get better with non-surgical treatment, a specialist may suggest an injection (King et al., 2019b).

How I can help (see the My Approach tab)

A graded strengthening programme for the thigh and tendon

Hands-on work for the thigh, hip and calf

Advice on training load, warm-up and footwear

Tips

Whenever exercising or training, make sure you have the proper footwear to prevent injury.
If you are overweight, you might want to consider losing a few pounds until you reach a healthy weight for your height and build.
If you play sports, know your limits and do everything you can to avoid overusing the muscles and joints. This is especially true when starting a new sport, or trying to increase participation too quickly.
Repeated strain on the tendon can make it harder for it to heal. Try to protect the area as much as you can. Chronic tendon problems can last months, so seek treatment from me or a physical therapist.
If you feel a sudden pop or tear above the kneecap and cannot straighten your knee, you may have torn the tendon (AAOS, n.d.). Call 911 or go to the emergency room at your nearest hospital, as people who need surgery do better if the repair is done soon after the injury (AAOS, n.d.).

Treatment

My Approach

Quadriceps tendon pain usually comes from asking the tendon just above your kneecap to handle more running, jumping or squatting than it's ready for. My aim is to settle it down, then build its capacity back up gradually, while changing whatever has been overloading it.

I start by assessing how your knee, hip and ankle move, testing your thigh, hip and calf strength, and watching how you squat, step down and run. I'll also ask about your training and footwear, because the hip, lower back or foot can add to the load on the knee.

Load Management

Cutting back the activities that flare it, such as jumping or deep squats, while staying active
Using the pain during activity and the next day as our guide: if it's steady or improving as we add load, we're on track; if it's climbing, we ease off

Strength and Loading

Starting with pain-free holds for the thigh, such as a wall sit or holding the knee straight
Building to slow squats, step-ups and step-downs, then slow lowering exercises, added gradually
Strength work for the hips and calves so the whole leg shares the load
A home programme between visits and, when you're ready, gym-based lifting and a graded return to running and jumping

Hands-On Treatment

Work through the thigh, hip and calf to ease tightness pulling on the tendon, including trigger point and myofascial work
Once it's past the early, irritable stage, cross-fibre work on tight spots around the tendon, followed by gentle stretching
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
Taping to ease the load in the short term, and I'll show you how to tape it yourself

If you feel a sudden pop above the kneecap and can't straighten your knee, get urgent help (see Tips).

What to Expect

Typical Course

Typical course: Most people come once or twice a week at first, then weekly, with a reassessment at about 4 to 6 weeks, then less often as you manage more on your own. Tendon pain usually takes weeks to months to settle, and long-standing cases can take around six months.

What I Focus On

Load Management

Progressive Thigh Strength

Quad & Tendon Release

Whole-Leg Assessment

Return to Sport

Sources

References

King, D., Yakubek, G., Chughtai, M. et al. (2019a) 'Quadriceps tendinopathy: a review—part 1: epidemiology and diagnosis', Annals of Translational Medicine, 7(4), p. 71. doi: 10.21037/atm.2019.01.58. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6409230/ (Accessed: 7 October 2026).
King, D., Yakubek, G., Chughtai, M. et al. (2019b) 'Quadriceps tendinopathy: a review, part 2—classification, prognosis, and treatment', Annals of Translational Medicine, 7(4), p. 72. doi: 10.21037/atm.2019.01.63. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6409233/ (Accessed: 7 October 2026).
Mosca, M.J., Rashid, M.S., Snelling, S.J. et al. (2018) 'Trends in the theory that inflammation plays a causal role in tendinopathy: a systematic review and quantitative analysis of published reviews', BMJ Open Sport & Exercise Medicine, 4(1), e000332. doi: 10.1136/bmjsem-2017-000332. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6045756/ (Accessed: 7 October 2026).
American Academy of Orthopaedic Surgeons (AAOS) (n.d.) Quadriceps tendon tear. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/quadriceps-tendon-tear/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooQuadriceps Tendinopathy

What It Is

Quadriceps Tendinopathy Anatomy

Self-Care & Treatment

How to Treat Quadriceps Tendinopathy

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Load Management

Strength and Loading

Hands-On Treatment

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooQuadriceps Tendinopathy

What It Is

Quadriceps Tendinopathy Anatomy

Self-Care & Treatment

How to Treat Quadriceps Tendinopathy

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Load Management

Strength and Loading

Hands-On Treatment

Typical Course

References

Related Conditions

Adductor Tear

Adductor Tendinopathy

Biceps Femoris Tendinopathy

Femoroacetabular Impingement (FAI)

Book a session