Massage therapy · Kitchener–WaterlooQuadriceps Tendon Tear

Recovery from a tendon tear can take a long time. After surgery for a complete tear, complete recovery takes at least 4 months, and many people need 12 months before they reach all their goals (AAOS, n.d.).

A quadriceps tendon tear often happens when there is a heavy load on the leg with the foot planted and the knee partly bent, such as an awkward landing from a jump in basketball or football (AAOS, n.d.). The quadriceps help you kick, run and jump, and they are prone to injury (Cleveland Clinic, 2025). Some therapists blame an imbalance of the quadriceps and hamstrings (on the back of the thigh). Some experts blame a shortening of the quadriceps, placing more stress on the tendon attachments. Either way, if the force going through the tendon is more than it can withstand, there is a risk of a tear.

Tears can be partial or complete. Most small, partial tears respond well to non-surgical treatment, but most people with complete tears need surgery to repair the tendon (AAOS, n.d.).

• not being able to straighten your knee
• an indentation or gap at the top of your kneecap where the tendon tore
• a kneecap that sags or droops
• difficulty walking because the knee buckles or gives way

If you have these signs after an injury, call 911 or go to the emergency room at your nearest hospital. People who need surgery do better if the repair is done soon after the injury (AAOS, n.d.).

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. Working together, the quadriceps muscles, quadriceps tendon and patellar tendon act like a pulley to straighten the knee (AAOS, n.d.).

A quadriceps tendon tear is not to be confused with a patellar tendon tear. The patellar tendon attaches the bottom of the kneecap to the shin bone (tibia), while the quadriceps tendon attaches above the kneecap (AAOS, n.d.).

2. Physical Therapy

Once your medical team allows, I can support your rehabilitation with exercises and hands-on work to restore movement and strength in your knee. See the My Approach tab for how I work.

Once the initial pain and swelling have settled down, you can begin physical therapy. Specific exercises help restore the strength and range of movement in your leg, and your physical therapist will gradually add exercises to your programme (AAOS, n.d.). Straight leg raises to strengthen the quadriceps are often a key part of physical therapy. As time goes on, your doctor or physical therapist will unlock your brace so you can move more freely, and more strengthening exercises will be added as you heal (AAOS, n.d.). You will be told when it is safe to return to sport (AAOS, n.d.).

Options outside my scope

• Imaging: an X-ray or MRI scan may be used to confirm the tear and show how much of the tendon is torn (AAOS, n.d.).
• Surgery: most complete tears are repaired with an operation that reattaches the torn tendon to the top of the kneecap (AAOS, n.d.). If you have surgery, follow your surgical team's own instructions for your recovery and rehabilitation.

How I can help (see the My Approach tab)

• Easing the areas working overtime while your knee is protected
• Swelling, stiffness and scar work once your team allows
• Rebuilding thigh strength and a gradual return to activity

If your calf becomes painful, swollen and warm, or you have chest pain or shortness of breath, call 911 or go to the emergency room.