Quadriceps tendonitis is a condition characterized by tissue damage and inflammation to the quadriceps tendon. This occurs at the point where the quadriceps muscle attaches to the top of the patella. The result is pain in front of the knee just above the patella.

The quadriceps muscle originates from the pelvis and thigh bone (femur) and inserts into the top of the patella which in turn attaches to the top of the tibia (shin bone) via the patella tendon.

Quadriceps tendonitis most commonly results from stresses applied on the supporting structures of the knee. Running, jumping, and quick starts and stops play a role in this condition. Overuse injury, which are typically associated with sports activities, is the most common etiology of quadriceps tendonitis, but even individuals who do not participate in sports or recreational activities can sustain such injury.

There are extrinsic (outside) factors that are linked with overuse tendon injuries of the knee, including:           - the wrong shoes

- errors in training (frequency, intensity, duration): training too much, too far, too fast, or too long, in addition to advancing the training level too quickly

- Inappropriate surface or ground (hard surface, cement) being used. 

Intrinsic (internal) factors such as age, flexibility, and joint laxity are also important. Misalignment of the foot, ankle, and leg can be major risk factors for tendonitis. Flat foot position, tracking abnormalities of the patella, rotation of the tibia can lead to increased and often uneven load on the quadriceps mechanism. Any muscle imbalance of the lower extremity can affect the quadriceps muscle and affect the joint. 

When we speak of overuse injury, we mean mismatch between load on the tendon and the ability of that tendon to distribute the force evenly onto its surface area. If the forces placed on the tendon are greater than the strength of the structure, then injury can occur. Repeated micro-trauma at the muscle tendon junction may overwhelm the tendon's ability to heal itself. Note that microtears do not appear on imaging.

So what to do? The target is to reduce the inflammatory process that accompanies the tendon injury. This is achieved by two means:

1- Relative rest: this signifies rest-to-recovery based on the severity of symptoms. Physical therapy can help in the early stages by decreasing pain and inflammation.

2- Anti-inflammatory drugs for 5-7 days.