What is Quadriceps Strain

Quadriceps strain is an injury to the muscles or tendons on the front of the thigh. The quadriceps muscles are used in straightening the knee and bending the hip. A strain occurs when the muscle is overstretched or overloaded.

There are three types of strains:

• Grade 1 is a mild strain. It involves a stretching or minor tearing of your muscle fibers or tendons. You should have little, if any, trouble using your thigh.
• Grade 2 is a moderate strain. It involves a partial tearing of your muscle fibers or tendons. You will have pain and some loss of strength in your thigh.
• Grade 3 is a severe strain. It involves a complete tearing of your muscle fibers or tendon. It causes severe pain and loss of strength in your thigh.

Recovery will take a few weeks or longer, depending on how bad your strain is.

What are the causes?

This injury is caused by overextending the muscles in the thigh.

What increases the risk?

The following factors may make you more likely to develop this injury:

• Participating in:
  • Activities that involve jumping or sprinting.
  • Contact sports, such as football or soccer.
• Having a previous injury to your thigh or knee.
• Having poor strength and flexibility.
• Not warming up properly before activity.
• Having one leg that is much stronger than the other.
• Exercising to the point of exhaustion.

What are the signs or symptoms?

Symptoms of this condition include:

• Sudden, severe pain in your thigh.
• Pain and tenderness over your quadriceps muscles. The pain gets worse when you use these muscles.
• Muscle spasm in your thigh.
• Bruising.
• Having trouble with tasks that involve using your quadriceps muscle, such as walking.
• A crackling sound when the tendon is moved or touched.

How is this diagnosed?

This condition may be diagnosed based on your symptoms, your medical history, and a physical exam. Your health care provider may order tests such as an X-ray, ultrasound, or MRI to further evaluate your injury and to rule out other conditions.

How is this treated?

Treatment for this condition may include:

• Resting your leg and avoiding activities that cause pain.
• Taking medicine to help reduce pain and inflammation.
• Applying ice to the area to relieve swelling and inflammation.
• Using crutches until you can walk without pain.
• Working with a physical therapist on exercises to restore strength and flexibility in your thigh.

In rare cases, surgery may be needed.

Follow these instructions at home:

Managing pain, stiffness, and swelling

• If directed, put ice on the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Activity

• Do not use the injured limb to support your body weight until your health care provider says that you can. Use crutches as told by your health care provider.
• Do exercises as told by your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Warm up and stretch before being active.
• Cool down and stretch after being active.
• Give your body time to rest between periods of activity.
• Make sure to use equipment that fits you.
• Be safe and responsible while being active to avoid falls.
• Do at least 150 minutes of moderate-intensity exercise each week, such as brisk walking or water aerobics.
• Maintain physical fitness, including:
  • Strength
  • Flexibility.
  • Cardiovascular fitness.
  • Endurance.

Contact a health care provider if:

• Your pain, bruising, or tenderness gets worse, even with treatment.
• Your leg becomes weaker.

Quadriceps Strain Rehabilitation

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your thigh. These exercises can also help to relieve stiffness or swelling.

Exercise A: Heel slides

1. Lie on your back with both knees straight. If this causes back discomfort, bend the knee of your healthy leg, placing your foot flat on the floor.
2. Slowly slide your left / right heel back toward your buttocks until you feel a gentle stretch in the front of your knee or thigh.
3. Hold for __________ seconds. Then slowly slide your heel back to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: Quadriceps stretch, prone

1. Lie on your abdomen on a firm surface, such as a bed or padded floor.
2. Bend your left / right knee and hold your ankle. If you cannot reach your ankle or pant leg, loop a belt around your foot and grab the belt instead.
3. Gently pull your heel toward your buttocks. Your knee should not slide out to the side. You should feel a stretch in the front of your thigh and knee.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your thigh. Endurance is the ability to use your muscles for a long time, even after your muscles get tired.

Exercise C: Straight leg raises (quadriceps and hip flexors)

Quality counts! Watch for signs that the quadriceps muscle is working to ensure that you are strengthening the correct muscles and not cheating by using healthier muscles.

1. Lie on your back with your left / right leg extended and your other knee bent.
2. Tense the muscles in the front of your left / right thigh. You should see your kneecap slide up or see increased dimpling just above the knee.
3. Tighten these muscles even more and raise your leg 4–6 inches (10–15 cm) off the floor.
4. Hold for __________ seconds.
5. Keep the thigh muscles tense as you lower your leg.
6. Relax the muscles slowly and completely after each repetition.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise D: Straight leg raises (hip extensors)

1. Lie on your belly on a bed or a firm surface with a pillow under your hips.
2. Bend your left / right knee so your foot is straight up in the air.
3. Tense your buttock muscles and lift your left / right thigh off the bed. Do not let your back arch.
4. Hold this position for __________ seconds.
5. Slowly return to the starting position. Let your muscles relax completely before doing another repetition.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Wall sits

Follow the directions for form closely. If you do not place your feet and knees properly, this can lead to knee pain.

1. Lean back against a smooth wall or door and walk your feet out 18–24 inches (46–61 cm) from it. Place your feet hip-width apart.
2. Slowly slide down the wall or door until your knees bend __________ degrees. Keep your weight back and over your heels, not over your toes. Keep your thighs straight or pointing slightly outward.
3. Hold for __________ seconds.
4. Use your thigh and buttock muscles to push you back up to a standing position. Keep your weight through your heels while you do this.
5. Rest for __________ seconds in between repetitions.

Repeat __________ times. Complete this exercise __________ times a day.