Q Angle: Effects of Isometric Quadriceps Contractions and Body Position

Q Angle: Effects of Isometric Quadriceps Contractions


  • Kashaf Arooj University Institute of Physical Therapy , Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
  • Faiza Sharif University Institute of Physical Therapy , Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
  • Ashfaq Ahmad University Institute of Physical Therapy , Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
  • Syed Amir Gilani University Institute of Physical Therapy , Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan




Quadriceps angle, patello-femoral pain, anterior knee pain , isometric contractions


Quadriceps angle or Q angle is quadriceps femoris angle and also called extensor muscle angle. It is formed from anterior superior iliac spine to the patellar center and from center of patella to tibial tuberosity. Q angle is linked many knee disorders like patella-femoral pain and varied in male and females. Objective: To evaluate the effect of change in anatomic positions like lateral deviation of tibia, tibial tuberosity and hyper-extended knee on the Q angle value Methods: Study is cross sectional in nature, randomized control trial adopted to select the healthy subjects without any recent and past knee injury. Ninety patients including 55 females and 35 males were chosen randomly. Q angle were measured goniometrically with contracted and relaxed state of quadriceps in both supine and standing position Results: The results shows that females have higher Q angle than male students and while during contracted state as compared to relaxed position. Q angle is greater in supine position than in standing position Conclusions: Females have higher Q angle and has more chances of knee injuries as compared to men. Different foot positions also affect the value of Q angle in supine and standing as well.


Raveendranath V, Nachiket S, Sujatha N, Priya R, Rema D. The Quadriceps angle (Q angle) in Indian men and women. Eur J Anat. 2009;13:105-9.

Merchant AC, Fraiser R, Dragoo J, Fredericson M. A reliable Q angle measurement using a standardized protocol. Knee. 2020 Jun;27(3):934-939. doi: 10.1016/j.knee.2020.03.001.


Imhoff FB, Cotic M, Dyrna FGE, Cote M, Diermeier T, Achtnich A, Imhoff AB, Beitzel K. Dynamic Q-angle is increased in patients with chronic patellofemoral instability and correlates positively with femoral torsion. Knee Surg Sports Traumatol Arthrosc. 2021 Apr;29(4):1224-1231. doi: 10.1007/s00167-020-06163-6. doi.org/10.1007/s00167-020-06163-6

Weiss L, DeForest B, Hammond K, Schilling B, Ferreira L. Reliability of goniometry-based Q-angle. PM R. 2013 Sep;5(9):763-8. doi: 10.1016/j.pmrj.2013.03.023. doi.org/10.1016/j.pmrj.2013.03.023

Flury A, Jud L, Hoch A, Camenzind RS, Fucentese SF. Linear influence of distal femur osteotomy on the Q-angle: one degree of varization alters the Q-angle by one degree. Knee Surg Sports Traumatol Arthrosc. 2021 Feb;29(2):540-545. doi: 10.1007/s00167-020-05970-1. doi.org/10.1007/s00167-020-05970-1

Sendur OF, Gurer G, Yildirim T, Ozturk E, Aydeniz A. Relationship of Q angle and joint hypermobility and Q angle values in different positions. Clinical rheumatology. 2006;25(3):304-. doi.org/10.1007/s10067-005-0003-6

Petersen W, Ellermann A, Gösele-Koppenburg A, Best R, Rembitzki IV, Brüggemann GP, Liebau C. Patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2264-74. doi: 10.1007/s00167-013-2759-6. doi.org/10.1007/s00167-013-2759-6

Gaitonde DY, Ericksen A, Robbins RC. Patellofemoral Pain Syndrome. Am Fam Physician. 2019 Jan 15;99(2):88-94.

Collado H, Fredericson M. Patellofemoral pain syndrome. Clin Sports Med. 2010 Jul;29(3):379-98. doi: 10.1016/j.csm.2010.03.012. doi.org/10.1016/j.csm.2010.03.012

Dixit S, DiFiori JP, Burton M, Mines B. Management of patellofemoral pain syndrome. Am Fam Physician. 2007 Jan 15;75(2):194-202.

Emami M-J, Ghahramani M-H, Abdinejad F, Namazi H. Q-angle: an invaluable parameter for evaluation of anterior knee pain. 2007.

Gulati A, McElrath C, Wadhwa V, Shah JP, Chhabra A. Current clinical, radiological and treatment perspectives of patellofemoral pain syndrome. Br J Radiol. 2018 Jun;91(1086):20170456. doi: 10.1259/bjr.20170456. doi.org/10.1259/bjr.20170456

Zago J, Amatuzzi F, Rondinel T, Matheus JP. Osteopathic Manipulative Treatment Versus Exercise Program in Runners With Patellofemoral Pain Syndrome: A Randomized Controlled Trial. J Sport Rehabil. 2020 Dec 17;30(4):609-618. doi: 10.1123/jsr.2020-0108. doi.org/10.1123/jsr.2020-0108

Lankhorst NE, Bierma-Zeinstra SM, van Middelkoop M. Factors associated with patellofemoral pain syndrome: a systematic review. Br J Sports Med. 2013 Mar;47(4):193-206. doi: 10.1136/bjsports-2011-090369.


Bloomer BA, Durall CJ. Does the Addition of Hip Strengthening to a Knee-Focused Exercise Program Improve Outcomes in Patients With Patellofemoral Pain Syndrome? J Sport Rehabil. 2015 Nov;24(4):428-33. doi: 10.1123/jsr.2014-0184. doi.org/10.1123/jsr.2014-0184

Nunes GS, Stapait EL, Kirsten MH, de Noronha M, Santos GM. Clinical test for diagnosis of patellofemoral pain syndrome: Systematic review with meta-analysis. Phys Ther Sport. 2013 Feb;14(1):54-9. doi: 10.1016/j.ptsp.2012.11.003. doi.org/10.1016/j.ptsp.2012.11.003

Hu H, Zheng Y, Liu X, Gong D, Chen C, Wang Y, Peng M, Wu B, Wang J, Song G, Zhang J, Guo J, Dong Y, Wang X. Effects of neuromuscular training on pain intensity and self-reported functionality for patellofemoral pain syndrome in runners: study protocol for a randomized controlled clinical trial. Trials. 2019 Jul 9;20(1):409. doi: 10.1186/s13063-019-3503-4. doi.org/10.1186/s13063-019-3503-4

Lee J, Lee H, Lee W. Effect of Weight-bearing Therapeutic Exercise on the Q-angle and Muscle Activity Onset Times of Elite Athletes with Patellofemoral Pain Syndrome: A Randomized Controlled Trial. Journal of Physical Therapy Science. 2014;26(7):989-92. doi.org/10.1589/jpts.26.989

Heiderscheit BC, Hamill J, Caldwell GE. Influence of Q-angle on lower-extremity running kinematics. Journal of Orthopaedic & Sports Physical Therapy. 2000;30(5):271-8. doi.org/10.2519/jospt.2000.30.5.271

Waligora AC, Johanson NA, Hirsch BE. Clinical Anatomy of the Quadriceps Femoris and Extensor Apparatus of the Knee. Clinical Orthopaedics and Related Research®. 2009;467(12):3297-306. doi.org/10.1007/s11999-009-1052-y




How to Cite

Arooj, K., Sharif, F., Ahmad, A., & Amir Gilani, S. . (2021). Q Angle: Effects of Isometric Quadriceps Contractions and Body Position: Q Angle: Effects of Isometric Quadriceps Contractions. THE THERAPIST (Journal of Therapies &Amp; Rehabilitation Sciences), 2(2), 08–14. https://doi.org/10.54393/tt.v2i2.32