Home › Blog › Strengthening the Quads in Knee Arthritis-It May be all about the Tendon…

Knee arthritis strengthening? So you’ve got knee arthritis and the physical therapist tells you to strengthen those big thigh muscles known as the quadriceps to help your arthritis pain. However, despite great effort, you never seem to get anywhere. Now a new study may explain why – it could be your knee cap tendon. The knee cap lives in the end of the quadriceps muscle and the patellar tendon attaches it all to the tibia bone. This muscle-tendon complex is the main mover that brings the knee into extension. In this new study, they used vibration to knock out the little sensors in the tendon in patients with and without knee arthritis. In the knee arthritis patients, they found that these little sensors were more prone to being knocked off line and that this resulted in less strength gain in the quadriceps muscle with exercise. The authors concluded that knee arthritis may impact these little sensors in the tendon which may lead to atrophy of the quadriceps muscles. This likely happens because these little sensors routinely tell the muscle to fire and less active sensors means less ability to contract the muscle. Why would the sensors be “off-line” in many patients? Our model (see our medical practice’s book, Orthopedics 2.0) would suggest that many of these patients have low back and spine problems that have gone undetected and that this leads to less position sense information from the quadriceps tendon, which in turn causes less control over the knee joint, and finally this sloppiness in joint leads to more knee arthritis. The upshot? This study supplies more evidence that arthritis is actually as much a disease of misfiring nerves as it is of structural problems in the joint. I’ve blogged on this before in the post, pain causes arthritis-arthritis doesn’t cause pain.

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile