Tony Parker's Quad Tendon: A Rough Road

During game 2 of the Houston-Spurs series, Tony Parker went down holding his left knee.  Here’s the play:

After an MRI, he was diagnosed with a ruptured quadriceps tendon. 

Understanding the Quadriceps and the Quadriceps Tendon

The quadriceps group (quads for short) are a set of 4 (hence, quad) muscles on the front of your upper leg that merge to form the quadriceps tendon, immediately above the patella aka knee-cap.  Here’s a picture of the quads:

 

As far as tendons go, the quad tendon is thick and durable - as it should be since it is the merger of 4 relatively large muscles. The tendon attaches to the top part of the patella.  Another picture for your anatomical pleasure:

The quads, via the quadriceps tendon, actively extend (straighten) the knee and passively stabilize the knee by controlling the rate of flexion (bending). 

Whenever the knee bends during activities such as walking or running, like in the picture below, the quads and quad tendon are stretched and stabilize the knee - this is called eccentric loading. And another one:

Without a functioning quadriceps tendon, you cannot walk normally, let alone complete things like running, jumping, cutting which place significantly more load onto the quads and quad tendon.

Tony’s Recovery

A quad tendon tear is pretty rare, for the reasons I mentioned above:  it’s a thick and durable tendon that is responsible for controlling a key muscle group. Rehabilitation is a long and arduous process.

After the quadriceps tendon has healed (he underwent a successful surgery to repair it), he will begin range of motion exercises and then usually around 6 weeks, quad strengthening. The quads will likely have significant atrophy.

A complicating factor throughout his rehab is that knee pain actually inhibits activation of the quads.  In other words, pain shuts down the quads from firing.  This inhibition loop makes any knee rehab a constant balancing act.  

For Tony, here’s the kicker:  He isn’t trying to recover just to get back to walking.  He’s a professional athlete in a sport that requires tons of quad strength and stability.  Therefore, he will have to rebuild a foundation of muscular strength in his quadriceps and all other supporting musculature. 

Variables We Don't Know

1 – Did he have a complete or partial rupture?  The former is far more severe than the latter.  Based on him going into surgery, I lean towards it being more severe but I can’t say with any kind of certainty.

2 – What’s his level of health like?  Yes, I know he’s a professional athlete but within that group, there’s still a wide spectrum. 

3 – How worn down is he? He’s been playing professional basketball since he was 17 and in the NBA since he was 19 (01-02 being his first season with SA).  While in the NBA, he has been in the playoffs every single year.  Needless to say, he has a ton of wear on his body.  That can certainly play a part in recovery and resiliency.

The Spurs put out a general timeline of 6-8 months for his recovery.  I wish him best of luck and a full one.  I'm sure a lot of us have counted him out before when it looked like he was moving in a jar of molasses and his jumpers were barely hitting the front lip.

Hope this provided some insight into the injury and why it can be a very difficult one to deal with. 

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