All four quadriceps muscles join together to form the quadriceps tendon. Part of this united band inserts into the patella and part of it passes anteriorly to the patella to join the connective tissue connecting the distal patella and the tibial tuberosity. The united band proximal to the patella is called the quadriceps tendon. Some people call the connective tissue band connecting the distal patella to the tibial tuberosity the quadriceps tendon, as part of this structure is the continuous connection from the quadriceps muscles to the tibial tuberosity. However, some people call the connective tissue connecting the distal patella to the tibial tuberosity the patellar ligament, as part of this structure is the direct connection of the distal patella and the tibial tuberosity. The recommendation is to name the united band proximal to the patella the quadriceps tendon and the distal band attaching to the tibial tuberosity the patellar ligament.

Guide the patient to sit. With the patient relaxed and with permission, place your fingers on the quadriceps tendon on the distal portion of the anterior thigh. Guide the patient to extend the knee, which tenses the quadriceps tendon. With unclear muscle activity, increase the contraction of the quadriceps femoris and therefore the quadriceps tendon by asking the patient to straighten the knee while you provide a push on the leg (i.e. body segment between the knee and the foot) in the direction of knee flexion.