The quadriceps muscle is located on the anterior side of the thigh assuming the functions of extension (straightening) of the knee and flexion of the thigh (raising towards the chest). It consists of four distinct segments - the femoral right, the lateral vast, the medial vast and the intermediate vast. In the upper part it is attached to the coxal bone and the femur bone and in the lower part it connects to the kneecap (patella) with the help of the quadriceps tendon.

Ruptures of the quadriceps tendon tend to be more common among people who run or do a lot of jumping.

Complete tendon ruptures, quite rare, are debilitating, a situation that may require surgery to regain the full function of the knee. In a complete rupture the soft tissue ends up dividing into two separate pieces.

Many tendon ruptures, however, do not disrupt the soft tissue in the knee area, resembling a rope stretched to the point where some of the fibers could be broken.

A tendon rupture is often worse than a muscle rupture, the muscle compared to the tendon tends to heal faster having a more elastic structure. The tendon is thicker, stronger but also stiffer, healing more slowly.

The four muscles of the quadriceps component (the femoral right, the lateral vast, the medial vast and the intermediate vast) meet above the kneecap forming the quadriceps tendon through which the aforementioned muscles attach to the patella.

As the muscles work together, they help to extend (straighten) the knee.

The rupture of the quadriceps tendon should not be confused with the rupture of the kneecap tendon (patellar tendon) that is below the kneecap, while the quadriceps tendon is above it.

The quadriceps tendon usually breaks during the practice of a sport, football, hockey and sprint being the most common causes.

In some situations, however, the tendon may rupture due to a muscular imbalance between the muscles located on the anterior side of the thigh (quadriceps) and those located on the posterior side (hamstring: femoral biceps, semimembranous and semitendinous).

Shortening the quadriceps muscle can put stress on the site where the tendon attaches to the bone, facilitating its rupture.

The ruptures of the quadriceps tendon are classified in 1st, 2nd and 3rd degree.

1st degree ruptures are mild and can take up to 6 weeks for complete recovery.

2ns degree ruptures are more severe and can take up to 12 weeks to recover.

3rd ruptures are the most serious and may sometimes require surgery to re-attach the tendon. Fortunately, 3rd degree ruptures are extremely rare.

Avoid the movements that cause or accentuate the pain, walk with the help of crutches in order to avoid placing the weight on the affected leg. The affected leg will be raised on a pillow or support above the level of the heart, to facilitate circulation and to remove the hematoma (bulge). In situations of severe rupture it may be necessary to wear an orthosis for the knees, for 3-6 weeks, the orthosis that keeps the knee straight.

Applied locally, in sessions of 10-15 minutes, 3-5 times a day, significantly helps reduce pain and inflammation. Always put a thin towel between the ice and the area on which it is applied.

Specific exercise programs begin as soon as the pain improves. Initially, the recovery program includes light exercises, stretching and toning (strengthening) of the muscles around the knee and their intensity will increase progressively. Strengthening the quadriceps is a key component of the recovery program, but also the correction of muscle imbalances between the anterior and posterior muscles of the thigh.

In time, the orthosis can be removed and will be worn only in the case of intense sports activities.

Physiotherapy procedures such as electrotherapy and laser help accelerate recovery, procedures that are done after physical therapy sessions.

It is necessary only in the case of complete 3rd degree ruptures and consists in the re-attachment of the torn tendon to the knee. The intervention is recommended immediately after the injury and is followed by recovery through physical therapy.

➢ Regular exercise increases both strength and flexibility of muscles and tendons.

➢ Do not skip the warm-up exercises before practicing a sport, especially in people who spend many hours at the office.

➢ Avoid the use of corticosteroids (stronger anti-inflammatories that are usually administered by local injections in case of injury), because these anti-inflammatories increase weakness in muscles and tendons.

➢ Avoid placing a heavy weight on a leg placed on the ground, especially when the knee is slightly bent, as it can result in a rupture of the tendon. ➢ Avoid direct blows to the front of the knee, as they can cause tendon ruptures or other injuries.

➢ After a rupture of the tendon, it may be necessary to wear the orthosis during some sports activities that are demanding for the knees, such as skiing, football, running, jumping.