Quadriceps tendinitis (also spelled tendonitis) is a painful condition affecting the quadriceps tendon above the patella (kneecap). The quadriceps group of muscles is the largest in the front of the thigh and is extremely important for stabilizing the leg. The group of muscles are individually called the vastus lateralis, vastus intermedius, vastus medialis and the overlying rectus femoris. The quadriceps tendon connects the quadriceps to the tibia (shins) via the patellar tendon, which surrounds the knee cap itself. The movement of the knee known as the quadriceps mechanism involves the patella (knee cap), the patella tendon, the quadriceps and its tendon. They all work together to extend the leg to straight.

Quadriceps tendonitis is caused by repetitive use of this tendon. This condition is most common in an athlete who is in involved in sports that require lots of jumping such as basketball, volleyball and jogging, or in a sport that requires a lot of stopping and starting. Little tears in the tendon and tendon sheath will present as pain and inflammation if these tears are not allowed to heal with rest.

Inflammation in the quadriceps tendon is often due to irritation and/or micro-tearing of the collagen fibers. When the fibers tear, they become weaker, inflamed and swollen causing pain and tenderness in the area.

There are 2 types of tendonitis, acute and chronic. Acute quadriceps tendonitis refers to inflammation that comes on suddenly, usually from a tendon strain or overloading it during exercise. Chronic quadriceps tendonitis occurs over time and generally results from long term repetitive use of the quadriceps tendon.

With both types of tendinitis, scar tissue develops on the tendon as the tears begin to heal. This scar tissue mends the tears in an abnormal way leaving the collagen fibers weaker and more prone to further injury. In the case of chronic quadriceps tendinitis, a build up of scar tissue over a long period of time will make the tendon and the entire knee joint more prone to re-injury.

Other conditions which can be a cause of anterior (front) knee pain are commonly confused with quadriceps tendonitis. These conditions include patellar tendonitis, synovial plicae, chondromalacia, patello-femoral subluxation and hyper-pressure, fat pad impingement or Hoffa's syndrome and patello-femoral arthritis.

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Quadriceps Tendinitis Risk Factors

• Participating in "jumping" sports such as basketball, volleyball and jogging.
• Having diabetes, gout or para-hypothyroidism.
• Age can be a factor because as we grow older our tendons become more brittle and therefore prone to injury.
• Activities that require sharp, sudden changes of direction or lots of stopping and starting.
• Mis-alignment of the foot, ankle, and leg including flat feet, leg length discrepancy, tracking abnormalities, etc.

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Quadriceps Tendonitis Symptoms

• Pain when tightening or flexing the quadriceps with a straight leg .
• Pain when the top of the kneecap is pressed.
• Irritation or pain when moving from a crouched position to a standing position.
• Stiffness or tightness the day following any activity or exercise that irritated the area.

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Quadriceps Tendonitis - Conservative Treatments

Your doctor will assess your particular case and determine a course of action. In most cases, a conservative treatment protocol will be enough to heal the injury, though in cases such as significant tearing or a fully ruptured quad, you will most probably require surgery. It is generally understood by doctors and surgeons, that surgery will introduce more scar tissue into the already damaged tissue. This added scar tissue will be problematic, requiring more visits to the PT clinic and conservative treatment options post-surgery. If not dealt with properly, your muscle injury could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort.

Some conservative treatment methods recommended include:

• Rest - This is important for initial recovery; rest and elevation will help reduce pain, swelling and inflammation in the early stages of injury. This can be difficult when you have to carry on with daily activities, but resting and elevating your knee whenever you can is recommended. During your recovery you will probably have to modify or avoid the activities that put stress on your knee until your pain and inflammation settles. However, too much rest can also be harmful, as knee and ankle immobility can actually cause stiffening in the joints. This is why rest should be used when reducing initial pain and swelling, but should not be considered for more long-term conservative treatment.

• Avoid Activities that Caused Your Knee Injury - While resting your injury it's also important to avoid all activities that may have caused your knee damage (especially any strenuous or repetitive movement). Continuing on with regular activities can increase the severity of your injury, turning a mild to moderate case of tissue damage into a downward spiral that can often severely impact your life. Also, trying to 'work around' your injury will eventually give rise to over-compensation injuries in other areas of your body.
• Use a Cold Compress or Ice Pack - Cold is very effective at reducing pain and inflammation - use at the onset of the injury and during flareups.
• Use Circulation Boost (a TShellz Wrap^®) - Once swelling has been reduced, you can assist your body in its recovery process by increasing blood flow to tissue in the knee. Improved blood flow to your knee in most cases, will help improve recovery time while improving overall health of soft tissue in the area. Promoting blood flow and heat to the treatment area will help to minimize the growth of scar tissue (less re-injury frequency), increase flexibility and help combat atrophy.
• Rehabilitative Stretching under supervision of a PT or doctor. The intent of this is to provide you with increased range of motion, pain relief and strengthening of the surrounding tissue of the joint. Doctors or surgeons typically won't perform a surgery until they feel that their patient has put effort into treating their injury with conservative treatment methods. This may include up to 4 to 6 months of visits to a PT clinic. If you haven't experienced any improvement in your condition during that time then surgery may be considered. Agressive PT approaches may focus on forced or manual manipulation of the leg/knee - this means your physical therapists will be trying to move your knee past the point of comfort as they strive to increase range of motion and prevent further atrophy. This can be painful and end up making your injury worse if not done correctly. (reference: 1)
• Stretching - Stretching your joint in PT and at home will help you to regain your range of motion much faster than not stretching at all. Stretching in many ways is key maintaining good Range of Motion (ROM) in your joint, and stretching can be made much easier with use of a TShellz Wrap^® before to warm up soft tissue, and a Cold Compress or Ice Pack treatment after to prevent any return of swelling and inflammation.

Stage 1: If the injury is very recent - use a good quality cold pack and Arnica Pain Relief Cream. If the injury has been going on for awhile, then skip to Stage 2 below.

An injured muscle, ligament or tendon will receive very little blood flow; this occurs for a couple of reasons: (1) swelling and inflammatory symptoms restrict blood flow, and (2) lack of movement (its painful!) reduces blood flow in the area. Add the two up and you can start to see why this can be a major problem over time. In cases where there is little to no inflammation (tendonosis, chronic tendonitis, muscle pulls) - the use of cold is relatively ineffective as there is little or no swelling to be dealt with.

If you are experiencing pain and swelling in the very early stages of the injury (first 48 to 72 hours), the first step in a conservative treatment protocol would be to focus on reducing the discomfort by applying a Cold Compress or Ice Pack to the soft tissue injury and incorporate the use of a high quality pain relief cream such as our Arnica Infusion Cream.

If you are experiencing pain and swelling, not only will you use cold for the first 48 to 72 hours after the injury, but you should also use it during other stages of the healing process. Some examples include...

• after any activity that stresses the muscle or tendon in a moderate way. It is wise to quickly apply cold to not only reduce the pain, but to also minimize tissue damage that may have occurred during the prior event.
• If you have a job that requires you to place some demands on your injury. If that is the case, use cold immediately following work and if the opportunity allows - use it for 15 to 20 minutes during lunch or another break time.
• If you are in a post-operative situation where cold compression would be utilized heavily for at least the first few weeks following the procedure. Similarly, if you are scheduled for upcoming surgery, then you will find a Cold Compress or Ice Pack helpful as well.

Having a Cold Compress or Ice Pack available at home to use if and when the need arises is helpful. Many of you already do so.

Often, however, too many people over-focus on cold while ignoring the most critical aspect to healing - nourishing injured tissue with a strong blood flow - the body's healing capability is generally dependent on blood flow..

This leads to the most important recommendation - Stage 2.

Stage 2: Focus on Increasing Blood Flow To The Injured Tissue - As This is The ONLY Way Soft Tissue Heals For the Long-Term

Even though the concept is simple, improving blood flow to injured tissues can be difficult. When the injury is in an area with low blood circulation (or you have a condition that affects your blood circulation), the challenges are even greater. Traditional methods require your muscles and tendons to move to promote blood flow (exercise), but that same motion that promotes blood flow can at times lead to making your pain and condition worse.

• Have you reinjured yourself by getting back on your feet too quickly?
• How many times in the past have you aggravated your old injury just trying to perform basic tasks around the home?
• Is your debilitation preventing you from work or activities you love to do?

Most people we deal with tell us these scenarios have happened to them many times in the past. Perhaps it has already happened to you.

Promoting blood flow within a muscle, bursa or other soft tissue injury to help the body heal itself is a concept that has been utilized for centuries. This is where the focus has to be if you are seeking long-term improvement.

Oxygen and nutrients, carried within the blood, are critical for the body to heal itself. Without proper blood flow, recovering from an injury or condition will be delayed...sometimes for a very long period of time.

The real challenge is how do you promote blood flow to an injury site without causing further injury (moving)? This goal is further complicated by the fact that muscles and tendons in the lower body are involved in pretty much every physical movement we perform each day.

Now, on to recommendation number two in the journey to heal your soft tissue injury...

The TShellz Wrap^® - Help Your Body Maximize Its Ability to Recover From Your Soft Tissue Injury

Energy emitted from the TShellz Wraps^® increases blood flow in and around the application area - we call this "LEC Response" (Localized Enhanced Circulation Response). The objective of the TShellz Wrap^® is to increase blood flow in these targeted areas, resulting in relaxation of the vessel walls. The vessels then gently expand, allowing for more nutrient rich blood flow along with extra oxygen to reach the damaged tissues. Plus, the enhanced blood flow helps in flushing waste and fluid build-up from the injury site - further enhancing the ability of the body to heal.

With a TShellz Wrap^® application, more blood begins to flow effectively to soft tissue within the body - for the length of the treatment and a short duration thereafter. Deep tissue needs the extra blood flow to heal as it is through the blood the body carries the oxygen and nutrients needed for proper and long-term healing.

The best option we came across in our research to accomplish blood flow to soft tissue in the upper and lower legs is the TShellz Wrap^®. Use of this device results in a dramatic increase in blood flow to the injured tissues in the treatment area - all in a non-invasive manner.

Have you seen what happens when you add water to a flower wilted from drought? In essence, your injured muscle/tendon/ligament is much like a "wilted" flower; your body wants to heal its injury, but needs lots of nutrients to do it. Blood brings new life to soft tissue by delivering healing nutrients and oxygen that are vital to your tissue. Without a good supply of blood, your soft tissue injury simply won't heal quickly, and as such increase your risk of reinjury and/or a chronic injury.

Using a TShellz Wrap^® will not expose you to the risk of causing further harm to soft tissue like you can when using rigorous exercise. The TShellz Wrap^® accomplishes the goal of enhanced blood flow without the need for intensive exercise and as such reduces your risk of re-injury.

Localized Enhanced Circulation Response

The intention of a TShellz Wrap^® is to ease pain by dilating blood vessels, decrease stiffness by elongating soft tissue, improve blood circulation, and boost metabolism and enzyme activity. In stimulating localized blood flow to damaged soft tissue, you provide needed oxygen and nutrients to grow new collagen. In addition, you will experience a clearing of toxins and excess fluid build up from the injury site. Over the intermediate term, this helps to reduce incidents of swelling as trapped fluids will be whisked away - reducing pressure on blood vessels.

Using the TShellz Wrap^® is truly a unique experience. Within moments of applying the wrap, you can feel the sensation due to the increase in blood flow within the area. During a treatment, and for quite some time after you finish, the treated area will feel relaxed and warm. It's a very soothing sensation and extremely effective.

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Who Should Use the TShellz Wrap^®

We recommend the use of a TShellz Wrap^®:

• If you have encountered a strain, tear or pull in your muscles, ligaments or tendons, then you would find the TShellz Wrap^® to be a great home treatment tool to use AFTER initial inflammation and swelling have been reduced.
• If you are dealing with conditions affecting your range of motion such as impingement or even arthritis.
• If you have a chronic tendonitis condition that has lasted for years- this device will help you kickstart the recovery process while helping improve tissue flexibility in the treatment area. Many of our past clients had suffered for years, then were completely amazed at the results only after a few months of treatments.
• If you are still working with a soft tissue injury, the TShellz Wrap^® will help relax injured soft tissue prior to work and after a day at the job.
• If you are still trying to enjoy your favorite activities such as gardening, tennis, golf, etc - use the TShellz Wrap^® prior to activity to help reduce chances of re-injuring or re-aggravating those targeted tissues.
• If you are suffering from bursitis and want to treat the major source of it (secondary damage to the muscle and tendon surrounding the bursa sac). Through overuse or degenerative changes in hip, knee and heel, muscle and tendons surrounding the bursa sacs will tighten and constrict. When they do, they place pressure on bursae (bursae=plural form of bursa), causing it to become irritated. Applying a soothing and deep penetrating energy to affected area helps relaxes muscles, tendons and ligaments - taking pressure off the bursa and boosting blood circulation in the area which enhances your body's natural healing process.
• If you are experiencing atrophy in your joint and want to reduce the chance of a strain or re-injury - this is a perfect treatment to use on a regular basis.
• If you have been to a physical therapist (PT) for soft tissue treatment (stretching, massage, strengthening, etc) and your PT or physician has recommended conservative treatments for home.
• If you need surgery for a soft tissue injury, then you will find a blood circulation booster to be a powerful tool after surgery to help surgically repaired tissues recover for long-term health. (once the surgery wound has healed and your physician has given the ok)
• If you are experiencing tightness in your muscle(s) and want to reduce the chance of re-injury while stretching - we recommend the use of a TShellz Wrap^® before you stretch.

Increased Blood Circulation = Increased Healing Capability

TShellz Wraps^® contain a unique Carbon Fiber Energy Pad which is flexible and will shape to conform to your body. This Energy Pad emits a uniform wave of perfectly safe energy over its entire surface. This energy is absorbed by soft tissue in the treatment area, opening blood vessels, resulting in an increase in blood flow. Increased blood circulation is what your body needs to accelerate the healing of soft tissue and this is why we recommend the TShellz Wrap^®.

The Leg TShellz Wrap^® is an FDA Registered Medical Device and is suitable for use in therapeutic clinics and FROM HOME. It is completely safe for people and patients to use for themselves.

The technology found in a TShellz Wrap^® has been used for decades in the worlds of professional and amateur sports - a contributing factor as to why athletes seem to recover from injuries so quickly.

Have you ever wondered by an athlete can return to activity after 3 or 4 weeks following a tendon injury - while your average person takes much longer to return back to normal? The secret isn't really that much of a secret - it involves consistent treatments (meaning multiple times a day) using a treatment like the TShellz Wrap^® to stimulate blood flow to the injured tissues. Most athletes have the luxury of using in-house facilities many times per day.

How many us can afford the time and money to visit a clinic multiple times a day? Very few indeed. This is how you can gain some of the advantages that athletes enjoy in their injury recovery - by using a device like the TShellz Wrap^® two or three times a day on a consistent basis.

Consistent Treatments = Consistent And Long Term Improvement

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What Else Makes the Leg TShellz Wrap^® So Special?

We believe the TShellz Wrap^® to be one of the most effective home treatments to increase localized blood flow to soft tissue in and around the treatment area.

We can promise that you will receive a product that is designed to be safe and does what it is supposed to do...quickly relieve pain and aid in the recovery from tendon, muscle and other soft tissue injuries.

The unit plugs into a standard wall outlet to get its power. The nice thing about the power supply is that the same unit can be used in North America and overseas as well. It has the capability to operate between 110v and 230v.

The TShellz Wrap^® has a special signal controller that can be set for 3 different power levels of application (3=High, 2=Medium, 1=Low). The cord is long enough that you can sit or lie comfortably and watch TV, read or surf the net while you're using it.

Treatments are max 30 minutes in duration and the device can be worn over clothing. This allows you to use the device at work, at home, or really anywhere you have access to an electrical outlet.

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When Should I Use My TShellz Wrap During the Day?

The most common question we receive from individuals prior to purchasing is - how many times a day should I be using my TShellz Wraps^® and when should I be using them? While treatment plans will differ for each individual and their specific injury, there are general guidelines that should be adhered to.

• Use a Cold Compress or Ice Pack when you are experiencing inflammation (usually after exertion or movement of the injury area).

The TShellz Wrap^® would then be used:

• Right after rising from bed in the morning (as this is when it is most stiff)
• Prior to going to bed at night (to relax the area, allowing for better sleep)
• Before you know you will be using your injured joint (going to work, driving, running, walking, etc).

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Stage 3 - In Between Treatments With TShellz Wrap^®, Apply Our New Fast Acting Pain Relief Cream Called ARNICA INFUSION

Dealing with aches and pains affecting the foot, ankle, leg, knee, hamstring, hip, back, arm, shoulder, elbow, wrist, or hand? If so, then applying the Arnica Infusion to any of these targeted areas will bring about fast relief from the pain and sore tissues. Simply apply a small amount of cream to the body and moments later, you will experience a soothing and comforting sensation over the area.

Arnica Infusion is specially designed to relieve pain due to sore muscles and joints associated with arthritis, backaches, sprains, strains, and bruises. No matter if you are dealing with an acute injury, chronic pain, or a general "flare-up" - you will experience fast relief from pain and inflammation.

This is a product that many of our current MendMeShop customers asked us to develop. So we focused our time and resources over the past few years and came up, with we believe, will be one of more effective, fast acting, topical pain relief creams on the market.

You are likely familiar with some of the standard topical agents on the market as most of our customers use them. The are mass marketed and even found in most department stores now.

Well, we are here to say that Arnica Infusion goes many steps beyond what they offer.

Made in the USA at an FDA registered manufacturing facility, you can be assured that Arnica Infusion is both safe and effective. We only source top grade ingredients while implementing strict quality control checks during every step of the production process. Expect the same high quality that MendMeShop customers have been accustomed to since we started the company in 2005.

The "Cool Blue" formula is the perfect balance between the smooth application of a cream and the effective absorbing factor of a gel. It is not too thick and not too thin - just the right texture. Best of all, it feels very nice on the skin!

Each application of Arnica Infusion feels so comforting and soothing, we are certain it will become an item you will not want to live without.

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Arnica Infusion Ingredients

The Arnica Infusion formula is based on a combination of scientific research and the use of high quality ingredients. The properties within the formula were chosen for their pain relief, anti-inflammatory, and soothing qualities.

The acting ingredients within the formula include ones many of us are familiar with; along with ones that have not received a lot of publicity (only in research circles). Extensive testing resulted in a blending of ingredients that provides the most synergistic of benefits.

The notable ingredients in the Arnica Infusion formula include:

• Arnica - powerful anti-inflammatory, speeds recovery, enhances circulation
• Menthol - provides deep penetrating pain relief with a nice cooling sensation
• Vitamin B6 - promotes normal nerve function
• MSM - supports healthy connective tissues, anti-inflammatory
• Ilex Leaf Extract - increases circulation, skin conditioner
• Vitamin E - anti-inflammatory, enhances circulation, hydrates the skin
• Aloe - anti-inflammatory properties, soothes the skin
• Tea Tree - enhances penetration of ingredients

Extensive quality control procedures during the manufacturing process ensure the ingredients and final product are both safe and effective. We would not stake our reputation on anything but the best.

When Do I Apply the Arnica Infusion?

While At Work

Apply Arnica Infusion at work to help reduce acute discomfort associated with overuse of muscles and joints. No matter if you are in a physical demanding job or work within an office environment, you will be placing stress on different parts of the body and aches and pains will result.

Before Or After Work, Sports, & Activity

If you suffer from a sprained ligament, pulled muscle, strained tendon, or even bruising - apply Arnica Infusion for quick relief of the pain.

Chronic Pain Suffering

Application of Arnica Infusion can be done up to a maximum of 4 times per day on a consistent basis to help bring about relief from various pains and aches.

In-between Treatments With the TShellz Wraps^®

Follow up your TShellz and Cold treatments with an application of Arnica Infusion. Combine the pain relieving benefits of Arnica Infusion along with the healing benefits of the wraps to make your recovery go much more smoothly.

Do not apply Arnica Infusion within a 2 hour timespan before a TShellz Wrap^® treatment.

Whether you decide to use the Arnica Infusion in conjunction with the TShellz Wrap^® and other treatments - or if you decide to use the cream as a stand-alone product - you will not be disappointed with the results. We guarantee it.

During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your knee area until your pain and inflammation settle.

The more diligent you are with your treatment and rehabilitation, the faster you will see successful results! We recommend that you consult your doctor and/or physiotherapist before using any of our outstanding products, to make sure they're right for you and your condition.

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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!