This is often very obvious on a side view X-ray of the knee. A review of the research, Runners of all ages and abilities commonly ask me what they should they be eating before running or during and after a competitive event: When should I eat before the 10K: 2,, I feel tired a lot. The force of muscle contraction is transmitted through the tendon to move the bone. Apart from the physical diagnosis, imaging tests are also prescribed for quadriceps tendon rupture (QTR). Typically surgery involves making an incision on the front of the knee. The pain will be located at the level of the knee or just above the knee joint. To determine the exact cause of your symptoms, your doctor will test how well you can extend, or straighten, your knee. Cylinder casting is more popular, which goes for 30-45 days. Surgery is performed to suture the torn tendon back to its attachment on the patella (kneecap). Most of the repair procedures are performed on an outpatient basis. Ilan D, Tejwani N, Keschner M and Liebman, M. Quadriceps Tendon Rupture. If the patients other medical problems prohibit the opportunity to perform the surgery safely in the first week, it can be delayed until the patient is medically fit for surgery. People who injure the extensor mechanism may tear the quad tendon, tear the patellar tendon, or fracture the kneecap. In the immediate time after the injury, quadriceps tendon tear symptoms include swelling that will develop quickly, at the front of the knee above the patella. In daily life, it acts as part of the extensor mechanism to straighten the knee. A quadriceps tendon tear, or quadriceps tendon rupture, is a painful condition that makes this. Partial tears. MD. Return to Play Full recovery and return to sport. Tendons often shorten if more than a month has passed since your injury. As time goes on, your doctor or therapist will unlock your brace. Begin gym strengthening including leg press. Twenty-seven years before this injury, the patient had suffered ipsilateral femur and comminuted patellar fractures, which were managed by intramedullary nailing and patellectomy respectively. A quadriceps muscle strain is a partial tear of the small fibers of the big group of muscles in the front of the thigh. The most common mechanism of injury was simple fall (61.5%). It usually takes around 4-6 months to recover from surgery for a quadriceps tendon rupture, and in some cases it can take up to one year to return to your usual activities. A quadriceps tendon rupture occurs relatively infrequently and usually occurs in athletes older than 40 years. Complex knee injury surgeon, Doctor Benedict Nwachukwu provides diagnosis as well as surgical and nonsurgical treatment options for patients in Manhattan, and New York City, NY who need a quadriceps tendon rupture repair surgery. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010. While it is not a surgical emergency, surgery does need to be performed in the first few days, or within the first week or two at the latest. You will most likely need crutches to help you avoid putting all of your weight on your leg. A quadriceps tendon rupture happens when the tendon tears. Therefore some degree of immobilization is usually indicated. A large tear of the patellar tendon is a disabling injury. Recovery for minor to moderate quad strains is usually . On physical examination the patient will be acutely tender to palpation directly above the patella. Your doctor will discuss your general health and the symptoms you are experiencing. Find a knee surgeon that performs quadriceps repair or patellar tendon tear surgery. Patellar tendon rupture recovery time after surgery varies based on surgeon preferences. 19,457 satisfied customers. Here are a few things to keep in mind with patellar tendon rupture recovery: No weight-bearing or limited weight-bearing on your injured leg for up to 4-6 weeks. The age of the person at the time of injury, persons lifestyle and general overall health state also play an important role. ; This tendon is classically in a trilaminar structure:; Superficial layer: rectus femoris muscle; Middle layer: vastus medialis muscle, vastus lateralis muscle; Deep layer: vastus intermedius muscle; This tendon continues to distal to the patella as the . In any case today - ~6 years post quad tendon surgery - every thing is fine. Acute traumatic, unilateral, quadriceps rupture after patellectomy is rare. 9/24/06. Quadriceps tendon tears can be either partial or complete. Copyright 2023 Lineage Medical, Inc. All rights reserved. What Happens With a Quadriceps Tendon Rupture. Range of motion will be blocked at 0 degrees in a brace for 4 weeks. Whats the Difference Between Tendons and Ligaments? Rehabilitation is lengthy following quadriceps tendon repair surgery, but most people recover normal activities., Jolles BM, Garofalo R, Gillain L, Schizas C. A New Clinical Test in Diagnosing Quadriceps Tendon Rupture. Complete recovery takes at least 4 months. Most people who undergo treatment of a quadriceps tendon rupture will do well long-term. Focus on proper quadriceps activation, especially VMO recruitment and patellofemoral mechanics should be the emphasis in the early stages of recovery. Patient should rest and avoid weight bearing for a multiple number of weeks. Talk to your doctor and physiotherapist on when to return to active sports following quadriceps tendon rupture. Gait no limp, good mechanics. These symptoms may cause gradually increasing pain over the kneecap and may be misdiagnosed as a kneecap problem. An incomplete injury to the quadriceps tendon may be described as: The key to differentiating this is whether or not the tendon is completely torn away from the kneecap. They most often occur among middle-aged people who play running or jumping sports. A complete tear will split the soft tissue into two pieces, or the tendon will completely separate from the bone. Patellar decompression with taping techniques as needed. Injuries to the quadriceps tendon can be very disabling. 2018;7(1):257-260. doi:10.4103/jfmpc.jfmpc_341_16, Ennaciri B, Montbarbon E, Beaudouin E. Surgical management of acute quadriceps tendon rupture (a case report with literature review). Quadriceps tendon ruptures have a good prognosis if they are diagnosed quickly. If you are an athlete and have been treated for partial or complete rupture of the quadriceps tendon, you should follow the below mentioned guidelines to continue with the recovery: Get To Know What Possibly Could Be Causing Your Symptoms! The quadriceps tendon is a confluence (coming together) of the four muscles that make up the muscles that extend the knee. Spontaneous ruptures were reported in 3.2% of cases. Surgery is typically recommended within a few days to a week after the injury. If required a surgery your surgeon must customize a unique plan for you for better recovery.[3]. What Causes a Quadriceps Tendon Rupture(s)? gout. When you are off your feet for a prolonged period of time, the muscles and tendons supporting your knees lose strength and flexibility. PNF patterns with resistance above the knee for hip and pelvic patterns. People who require surgery do better if the repair is performed soon after the injury. If your rupture is not a complete tear, there are other options. Most repairs are nearly healed in 6 months. Having talked to many other quadders over the last few years, the factors that pertain to the speed of recovery depend on several factors. Clinical outcomes after repair ofquadricepstendonrupture: a systematic review. Quad tendon repair with allograft post-operative physical therapy protocol Download PDF General considerations The surgical leg will be weight bearing as tolerated using crutches post-operatively. How long after quad tendon surgery can you drive? There are two types of tears: partial and full. This injury is generally due to an acute stretch of the quadriceps muscle, again and again at the same time as a forceful compression or repetitious functional . Without this attachment, the knee cannot straighten when the quadriceps muscles contract. After six weeks, progressive strengthening is started as well as increasing range of motion. Aggressive work with a physical therapist to help regain range of motion and strength is critical. Recovery times can vary, depending on the extent of the injury. Your doctor will discuss with you when it is safe to return to sports or other physical activity. It should be noted that rehabilitation protocols are often very specific to the type of injury and the type of repair that was achieved at the time of surgery. Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. Focus on gait mechanics. The tendon plays an important role in your ability to extend the leg in order to walk, climb stairs, run, and play sports. Quadriceps tendon is a thick tissue located at the top of the kneecap. The initial weight of post operation is managed with a walker or crutches. Contact Dr. Nwachukwu's team today! My New BQR Friend, Jim Falvo's Amazing Story. I was also 6 years younger and had more free time (no dogs, no regular job) to tend to my full recovery. It. This is a comprehensive Q&A collection on MCL and PCL injuries, patellar dislocations, patellar and quad tendon ruptures, knee dislocations and more. Two-legged bicycling for range of motion and without resistance and without forcing range of motion. I heard a distinct "pop, pop, pop" in both legs as they collapsed. There are many injuries to consider when a patient may have a quadriceps tendon rupture. M.D., office visit day 2 for dressing change, review of medications and instruction on a home program. In case of cast, isometric quadriceps exercises are initially prescribed by physiotherapists. Immobilization. A quadriceps tendon rupture is a traumatic injury of the quadriceps insertion on the patella leading to a disruption in the knee extensor mechanism. Chronic diseases which may weaken the tendon include: Steroid use. It is particularly well suited for sports injuries such as a torn quad and facilitating the diagnosis of the severity of the injury and a treatment plan. Additional symptoms include: Doctors use the knee extension test to help diagnose a quadriceps tendon tear. Your surgeon will remove sutures or staples about two weeks after surgery. The kneecap moves out of place when the quadriceps tendon tears. Posts: 14. Suegeons may alternatively use suture anchors to reattach the tendon to the bone. While it is not a surgical emergency, surgery does need to be performed in the first few days, or within the first week or two at the latest. A quadriceps tendon tear is debilitating if not treated. Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina and Charlotte, North Carolina. Straight leg raises to strengthen your quadriceps are often central to a physical therapy plan. Surgical repairs are best if they are carried out in the initial stage of quadriceps tendon rupture (QTR). THE CONTENT DOES NOT AND IS NOT INTENDED TO CONVEY MEDICAL ADVICE AND DOES NOT CONSTITUTE THE PRACTICE OF MEDICINE. Rehabilitative exercises should be followed once the healing of the rupture is complete. Jonathan Cluett, MD, is board-certified in orthopedic surgery. Patellar and quadriceps tendon ruptures are difficult to prevent, but regular exercise, stretching, and proper warm-ups and cool downs may help. This is a more aggressive approach and not appropriate for all patients. Physical therapy. This article does not provide medical advice. Quadriceps Tendon Rupture: Exercise, Yoga, Braces, Prognosis, Healing Time, IT Band Syndrome or Iliotibial Band Friction Syndrome (ITBS or ITBFS), Home Remedies and Exercises for Knee Sprain, Dietary Dos and Donts for Migraine Sufferers, Shirshasana (Headstand) Versus Inversion Therapy Using Inversion Table, Understanding Joint Pain and Tips to Get Relief Using Home Remedies, Erectile Dysfunction: Does Opioid Cause ED, Libido: Opioid Induced Female Sexual Dysfunction, Any prior injury to the quadriceps muscle, Medical conditions due to quadriceps injury. It is important to be very diligent with the appropriate prescribed physical therapy to ensure a good outcome. Looking back now with my first quad tendon injury, I healed rather quickly. These include: patellar (knee cap) fracture,patellar tendon rupture,fracture of the end of the femur (thigh bone) or top of the tibia (shin bone), torn ACL,andpatellar dislocation. Considerations. We follow a strict editorial policy and we have a zero-tolerance policy regarding any level of plagiarism. The patella is attached to the shinbone (tibia) by the patellar tendon. A complete tear of the quadriceps tendon is a disabling injury. Quadriceps tendon rupture recovery time. They can cause significant loss of time from sport and work. Rehabilitation program for quadriceps tendon rupture including quadriceps strengthening and proprioception exercises should be undertaken. Several things can lead to tendon weakness. Surgery generally takes between one and two hours. Tendons are strong bands of tissue that attach muscles to bones. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. You can expect to be in a knee immobilizer or brace for 3 to 6 weeks. Again, my recovery will be different than yours, but hopefully it will give a rough overview of the timeline of recovery. In order for a partial tear to be treated without surgery, the patient must be able to do astraight-leg raiseand have good strength with this physical exam finding. Running program, balance drills and agility program. Complete tears can often be identified with these X-rays alone. After six weeks, quadriceps strengthening is begun. The knee strength has to be gained till 85 to 90 percent. With time, grade two tears heal, although recovery is slower than with a grade one injury. Complete recovery takes at least 4 months, but most repairs are almost completely healed within 6 months. Better knee function after surgical repair of acute quadriceps tendon rupture in comparison to acute patellar tendon rupture. The diagnosis is confirmed by doing an appropriate physical examination and also through imaging studies. It almost always requires surgery, followed by physical therapy to regain full knee motion and function. I will add more info to this timeline as I go through more of my data: January 6th - Bilateral Quadriceps Tendon Accident, January 8th - Doctor's Appointment and MRI, January 9th - Surgery of Bilateral Quad Tears, Received Leg Braces to wear and locked at 0 degrees ROM for next 6 weeks for tendons to heal and repair themselves, January 23rd - 2 Week Follow Up with Doctor / removal of staples, February 22nd - 6 Week Follow Up / cleared for starting PT, Given the ok to start increasing ROM on braces at 20 degrees per week, February 27th - First Physical Therapy Session (initial PT frequency at 2x per week), March 1st - ROM Increased to 40 degrees via braces, March 8th - ROM Increased to 60 degrees via braces, March 15 - ROM Increased to 80 degrees via braces, March 22 - ROM Increased to 100 degrees via braces, March 31 - Physical Therapy Session Frequency at once per week, April 1st - 15 minutes of stationary bike full rotation, April 5th - 12 Week Follow Up / cleared for brace removal, April 15 - Last Physical Therapy Session. There has been some suggestion that quadriceps tendon ruptures are more common among athletes who have taken steroids, either illegally or for medical reasons. Continue to progress weight bearing and functional mobility as able. Return to sport is governed by the ability to pass functional tests specific to the sport (example: jumping for a basketball player). Q: Ruptured Quadriceps Tendon: I am a 51 year old runner, been running for 13 years, ten marathons, and I wear orthotics. Since I had only one leg to deal with, it didnt take as long as my second injury. The quadriceps tendon is a member of the knee . How long you need therapy and which exercises your treatment team prescribes will be based on the type of tear you have, your surgical repair, your medical condition, and your needs. The brace can usually be discontinued after three months, and sports resumed in four to six months. visit at 1 month post-op. Your doctor and physical therapist will customize a rehabilitation plan for you. They can cause significant loss of time from sport and work. San Francisco, CA 94123, United States. The area where the tendon is ruptured off of the bone is exposed. Grade 3 Quad Tear We present a 42-year old male who experienced a unilateral left quadriceps tendon rupture following assault by four people. Initiate gentle patellar glides and portal scar tissue mobilization when appropriate. Stitches are placed in the tendon, and these sutures are used to repair the tendon back to the top of the patella. Treatment Options Chronic disease. thigh for patellar tendon ruptures and slips downward for quadriceps tendon ruptures. Their main action is to extend the knee and leg. If these are negative, then an MRI scan can be obtained to evaluate the integrity of the quadriceps tendon. If not treated appropriately, these injuries can have many negative long-term sequelae, however if diagnosed quickly and treated appropriately, one can expect a full recovery from a quadriceps tendon rupture. The healing process of quadriceps tendon rupture will be fast and improved. Learn more via SportsMDs 24/7 Telemedicine Service. At 4 to 6 weeks 0 to 50 degrees. This is done in the surgeon's office. If you are a competitive athlete, your surgeon will do very thorough assessment before giving a go-ahead to return to your sport. Elasticized compression bandage around the injury can be used. Without an intact quadriceps tendon, straightening the knee and walking normally can be difficult. Quadriceps tendon rupture (QTR) is determined in people who do not automatically have a reflex. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. You may be allowed to put your weight on your leg with the use of a brace and crutches (or a walker). Gait weight bearing as tolerated with brace locked in 0 degrees extension. X-rays of the knee usually reveal the abnormal position of the patella, indicating a rupture of the patellar/quadriceps tendon. Thus, you can move your leg freely. Then range of motion exercises are started between 3-6 weeks from the injury. How long does it take to recover from ruptured quadriceps tendon? Doctors ask patients to lie down on the examination table and then squeeze the quad muscle to check the reflex. Thank you all for the insight and sharing this journey. Why am I so Tired? Partial tears can sometimes be treated non-operatively. It may take even longer to completely achieve strength training and range of motion goals. 395. The quadriceps tendon ruptures typically occur during an eccentric contraction where the quadriceps muscle is contracting, but the knee is being straightened. Increase your normal warm up time by at least 10 minutes in order to increase blood flow to the area. We wish him a speedy recovery. The above protocol is just an outline of typical rehabilitation. However, an MRI can show the amount of tendon torn and the location of the tear if this information is needed. The quad tendon is part of the extensor mechanism of the knee that includes the quadriceps muscle, the quad tendon, the kneecap (patella) and the patellar tendon. The shoulder took more like 18 months. The treatment procedure may be long and more complicated due to delayed initiation of treatment. A quadriceps tendon rupture is a devastating injury to the knee that uncommonly occurs in sports. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. Return to sports activities can often take six months from the time of surgery. Small tears of this tendon cause pain or make it difficult to walk and participate in other daily activities. THE SITE IS NOT RESPONSIBLE FOR ANY ACTIONS OR INACTION ON A USERS PART BASED ON THE INFORMATION THAT IS PRESENTED ON THE SITE. Quadriceps tendon rupture is the loss of congruency, either partial or complete, of the quadriceps tendon. There is oftentimes a palpable defect in this area when compared to the contralateral side (uninjured knee). Chapter 22 1513-1525. An MRI is not typically necessary after this injury, as the physical examination is usually telling. Pain and swelling typically follow, and you may not be able to straighten your knee. Patients may experience significant swelling or bruising, or notice a divot or gap if they feel the area above the kneecap. I usually place the patient in a hinged knee brace that is locked with the knee in full extension for approximately two weeks before slowly instituting some knee flexion. Surgery is usually done within a few weeks of the injury, as some reports have shown that delayed treatment may lead to less successful results. Treatment consists of surgery and postoperative immobilization for at least 6 weeks. Most people with a quadriceps tendon rupture will note the acute onset of pain and disability in the affected leg. Surgery does bring the tendon back down to the top of the patella, but the surgeon has to ensure that the tendon heals in that position. Range of motion will be blocked at 0 degrees in a brace for 4 weeks. Neither SportsMD Media, Inc. nor SportsMD.com dispense medical advice. J Family Med Prim Care. This quadriceps tendon is a thick tendon which is extending to the patella & made up of contributions from all four quadriceps muscles. However, no study has compared QT autografts with bone-patellar tendon-bo. This past summer I ruptured my quad tendon right at the connecting point . Watford FC has confirmed Etebo will be out for 4-5 months with a torn quad muscle. Inflammation: For the first 3-5 days, the area may feel swollen while the body works to heal itself. Are Low Calorie Sweeteners Good For Athletes? To provide extra protection to the repair, some surgeons use sutures or cables to help hold the kneecap in position while the tendon heals. "We think that stimulates healing," Wilckens says. Quadriceps tendon ruptures come in two main types: partial and complete tears. This article may contains scientific references. In some cases, your doctor will prescribe an immediate motion protocol (treatment plan). Most of the distal central tendon injuries were grade I (14) or II (20) with only one complete tendon tear. Quadriceps tendon tears are not common. Rauh, M and Parker, R. Patellar and Quadriceps Tendinopathies and Ruptures. Treatment for a quadriceps tendon rupture - Surgery. Warm up prior to exercise. When quadriceps tendon ruptures are not identified early, it can be more difficult to fix with surgical repair. Without an intact quadriceps tendon, straightening the knee and walking normally can be difficult. The patellar tendon works with the muscles in the front of your thigh to straighten your leg. (Left) This X-ray taken from the side shows the normal location of the kneecap. This information is provided as an educational service and is not intended to serve as medical advice. Should I get a Femoral Nerve Block before Quadriceps Tendon Surgery? This can happen during high-energy accidents such as motor vehicle crashes and during sporting activities or during low energy injuries such as falls from a standing position. Heat and ice therapy for quadriceps tendon rupture helps in pain and swelling. It works together with the quadriceps muscles to allow us to straighten our leg. The athlete knows that a serious injury has occurred. All that's holding the tendon to the kneecap are some. Journal of the American Academy of Orthopaedic Surgeons. Using these anchors means that the surgeon does not have to drill holes in the kneecap. Complete tears, as well as partial tears when the patient is unable to perform a straight-leg raise, are always treated with surgery. A partial rupture does not completely damage the soft tissue. Recommended Products and Resources Quadriceps Tendon Rupture Symptoms Inflammation of the quadriceps tendon, called quadriceps tendinitis, weakens the tendon. Eccentric focused strengthening program. They connect the quadriceps muscle to the shin bone and, less precisely, are sometimes called patellar ligaments. The quadriceps tendon works together with the quadriceps muscles to allow us to straighten our leg. Magnetic resonance imaging (MRI). When a quadriceps tendon tears, there is often a tearing or popping sensation. Surgical repair is still possible but may require special techniques to do so and an extended rehabilitation protocol. Begin functional exercises such as partial squats, bent leg bridges, small range slider lunges, mini step ups. Yoga Poses for Quadriceps Tendon Rupture (QTR) Other than medical procedures, Yoga can be one most beneficial therapy to recover from quadriceps tendon rupture (QTR). All from the comfort of home. Extension stretching to hamstrings, calves, and lateral musculature to maintain extension range of motion. You will be prescribed more strengthening exercises as you heal. X ray-The sideway image is essential to determine the quadriceps tendon rupture (QTR). An immediate treatment and quick diagnosis is required to undergo a correct treatment of quadriceps tendon rupture (QTR) and early recovery. Contact Hoag Orthopedic Institute today to schedule a consultation with one of our knee doctors. If, like many of our patients, you don't live in the Bay Area, we offer a complimentaryphone consultation service. Complete recovery takes at least 4 months. Complete recovery takes at least 4 months, but most repairs are almost completely healed within 6 months. This will enable you to move more freely with a greater range of motion. Operative repair is indicated if there is disruption of the extensor mechanism. Not only is it yummy, it is also health-promoting and performance enhancing. A quadriceps tendon tear or rupture is an injury that occurs when the tendon that attaches to the quadriceps muscle (a group of 4 muscles in the front part of the femur) to the patella or kneecap tears. Well legged cycling, upper body work outs. This sometimes involves using donated tissue (allograft). DeLee and Drez Orthopaedic Sports Medicine: Principles and Practice. I will break down a rough timeline on my bilateral quadriceps tendon rupture recovery below since I took more detailed notes for that event. About 2 weeks after surgery, your surgeon will remove your skin sutures or staples. The quadriceps tendon is important because it allows the knee to be extended. The surgical leg will be weight bearing as tolerated using crutches post-operatively. Completely tore my left quad tendon April 26 stepping from a stair to a sloped sidewalk. He is the director of adult spinal deformity & complex spinal reconstruction at Massachusetts General Hospital and is on the faculty at Harvard Medical School. Sport-specific exercises and training program. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. The quadriceps tendon is the tendon that extends from the quadriceps muscle of the thigh to the top of the patella (kneecap). Complete Sports test 1. If there are no complaints in these 10 days, the mobilization is extended. This results in immobilization of the knees for 21 to 42 days. The recovery from that was longer and more painful but I started easy climbing again in June and pretty much back to normal with the knee at that point (8 months post surgery). The following is my timeline from my 2013 incident. A quadriceps tendon rupture is an uncommon injury that typically requires surgical treatment. The x-rays of a patient with a quadriceps tendon rupture may show patellar baja (a knee cap that is lower than normal). Without surgery, the patient will be unable to extend their knee and have significant long-term disability. Overall, it is part of the lower extremitys extensor mechanism. The quadriceps muscles are the muscles located at the front of the thigh. With a partial tear, the tendon is intact but frayed, like a rope. Re: Total Quadriceps Tendon Rupture rehab.. by rshoffer May 9th, 2015, 3:05 pm. Your doctor may ask you about the following questions to confirm quadriceps tendon rupture (QTR): Doctors usually ask the patients to extent their knees in front of him/her to determine the condition of knee. For a player, returning to 100 percent following a ruptured patellar tendon is a long and grueling process and there is no guarantee that they'll be able to return to form. Immobilization. Active open chain hip extensions, adductions, abductions progressing to resistive band exercises as appropriate (proximal to the knee). Rotator Cuff and Shoulder Conditioning Program. 3727 Buchanan St #300 Physical therapy for quadriceps tendon rupture is started only once the pain and swelling is gone. As the story goes Clinton was at the home of golfer Greg Norman in March 1997. Really there are very few risk factors. Using corticosteroids has been linked to increased muscle and tendon weakness. Following surgery, most surgeons recommend a brace to protect the repair. Via phone or video from home or anywhere. This also ensures that the position of the kneecap closely matches that of your uninjured kneecap. Some questions that arise: Are these products, Athletes tend to do a good job of training their muscles, heart and lungs. Progression will be based on individual patient presentation, which is assessed throughout the treatment process. The patellar. I suffered a bilateral quad tendon rupture in Jan 2018. Small tendon tears can make it difficult to walk and participate in other daily activities. Tears can also be caused by falls, direct force to the front of the knee, and lacerations (cuts). What Are Acute Injuries of the Patella (Kneecap)? lateral stepping, lateral step-ups, etc.).