Quadricep Strains

What is a Quadricep Strain?

Quadricep Strain Overview

Quadricep Strain Description

• A quadriceps muscle strain is an acute tearing injury of the quadriceps.

• Quadricep strains are most common in the rectus femoris, which is more vulnerable to strain as it passes over two joints: the hip and the knee.

• Injury to the quadricep muscle group can be painful and debilitating.

• Quadricep tendon rupture is a uncommon debilitating diagnosis, occurring more often in older male populations.

Anatomy of a Quadricep Strain

• The quadricep muscle group is composed of 4 subcomponents: rectus femoris, vastus lateralis, vastus medialis and vastus intermedius.

Presentation of a Quadricep Strain

• Onset: sudden pain in the anterior thigh during an activity requiring explosive eccentric muscle contraction.

  There a generally three mechanisms of injury for the quadriceps:

1. Sudden deceleration of the leg (e.g. kicking)

2. Violent contraction of the quadriceps (e.g. sprinting, jumping)

3. Rapid deceleration of an overstretched muscle (e.g. quick change of direction)

• Localized pain and tenderness at the front of the thigh

• For severe strains swelling and bruising may be present.

Quadricep Strain Grades

• Grade 1 (mild) strain: affects only a limited number of fibers - is a minor injury with pain on resisted active contraction and on passive stretching. A twinge may be felt in the thigh and a general feeling of tightness. An area of local spasm is palpable at the site of pain. An athlete with such a strain may not cease activity at the time of the pain but will usually notice the injury after cooling down or the following day.

• Grade 2 (Moderate) strains: nearly half of muscle fibres torn – the athlete may feel a sudden sharp pain when running, jumping or kicking. It may cause significant pain on stretching as well as on unopposed active contraction. There is usually a moderate area of inflammation surrounding a tender palpable lesion. The athlete with a grade II strain is generally unable to continue the activity.

• Grade 3 (Complete tears): of the rectus femoris occur with sudden onset of severe pain at the front of the thigh and disability during intense activity. Bad swelling will appear immediately and significant bruising within 24 hours. A muscle fibre defect is usually palpable when the muscle is contracted. In the long term, they resolve with conservative management, often with surprisingly little disability.

Quadricep Strain Treatment

Managing your Quadricep Strain

Quadricep Strain Rehabilitation protocol

• Stage 1 (control hemorrhage):

  • RICE: rest, ice, compression, elevation

  • Soft tissue massage: gentle massage

  • Stretching: gentle stretch till onset of pain

  • Strengthening: static muscle contraction is possible

• Stage 2 (restore and maintain pain-free range and muscle strength)

  • Maintain compression: ice after exercise

  • Soft tissue release: gentle massage

  • Stretching: increase stretches

  • Strengthening: static muscle contraction through range, stationary bike, pool (walk/swim/kick), concentric/eccentric exercises

• Stage 3 (functional rehabilitation)

  • Soft tissue release: moderate massage

  • Maintain stretching

  • Strengthening: gradually increase stage 2 exercise repetition, speed and resistance

• Stage 4 (gradual return to sport)

  • Soft tissue massage: firm

  • Exercises: sports specific exercises, agility drills, plyometrics

  • Must complete full training before return to sport

Quadricep Strain Prognosis

• Mild strain = 1-2 weeks

• Moderate strain = 2-4 weeks

• Severe strain = 6-12 weeks