Quadriceps Strain

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Man with quadriceps pain possibly due to a strain

Quadriceps strain injuries are caused by damage to the group of muscle fibers at the front of your thigh. The damage can be classified as overstretching, partial tearing or a complete tear of one or more of these muscles. The mildest form of the injury is an overstretched muscle (no tearing) and this is known as a pulled quad muscle.

Symptoms typically include pain at the front of the thigh and swelling and bruising in the same area. With the more severe injuries, the patient may have difficulty walking without a limp.

Unless the quadriceps strain is in the highest category of severity (i.e. involves a completely severed muscle) your doctor will typically opt for treatment at home. You will be recommended to rest your thigh by refraining from sports or other strenuous activities. Icing the painful area, applying compression to it and elevating it above heart level when possible are other common remedies.

A quadriceps strain is one of the 3 possible types of muscle strains in the thigh. The other 2 being hamstring strains and adductor strains (also called groin strains).

Anatomy Of The Quadriceps Muscle Group

The quadriceps muscle is actually comprised of 4 sub components:

  • The Rectus Femoris in the upper central part of the front of the thigh;
  • The Vastus Lateralis, located in the outer side of the front of the thigh;
  • The Vastus Medialis, which is near the bottom of the quadriceps area and near the inner side of the thigh;
  • The Vastus Intermedius, which is located near the inside of the thigh but lies above the Vastus Medialis.

The rectus femoris is the only component of the quad muscle group that crosses both the hip and knee joints. As a result, it tends to be the component most frequently involved in quadriceps strain injuries.

Quad Strain Risk Factors

This injury is more prevalent among individuals who frequently play sports. Sports involving plenty of running or jumping tend to increase the quad strain injury risk. In addition, sports requiring sharp accelerations, decelerations or changes in direction while running are particularly likely to produce a quad strain.

The other risk factors that may increase your risk of experiencing this injury are:

  • Tight quadriceps muscles, since tighter muscles are more likely to experience overstretching or tearing when subjected to stress. Looser, more supple muscles are less likely to suffer a strain;
  • An imbalance of muscle strength between the quadriceps muscles and the hamstring muscles at the opposite side of the thigh. The hamstring muscles may be far stronger than the quads. If so, the latter may be under excess pressure to keep up with the demands imposed by the hamstrings;
  • Weak or fatigued quadriceps muscles;

Types Of Quadriceps Strains & Their Symptoms

Quad strains can be placed into one of 3 grades depending on the severity of the injury:

  • Grade I (or mild) strains involve only overstretching of the muscle – no tearing, whether partial or complete. You will experience some tightness at the front of the thigh but no real pain. There should be little (if any) bruising, discoloration or swelling of the thigh;

If you experience a grade I strain, you should not have much interference with your ability to walk or run. You should also retain most (if not all) of your knee and hip range of movement.

  • With a grade II (or moderate) quadriceps strain, you may experience a popping or snapping sensation at the front of the thigh when the injury occurs.This will be accompanied by a sharp pain in the same area. The pain will be severe enough to interfere with your ability to walk or run freely (i.e. without limping).

In addition to the above symptoms, those experiencing a grade II quad strain will likely experience swelling at the front of the thigh. Bruising may also be present. There will be a loss of knee and hip range of motion as a result of the role the quad muscle plays in knee extension and hip flexion.

  • Grade III quadriceps strains represent the most severe injuries. They are characterized by a complete severing of one or more quad muscles.

The victim of a grade III quad muscle strain will experience the popping or snapping sound described above at the time of occurrence of the injury. There will also be intense pain and significant difficulty running or even walking.

In addition, the patient will likely notice significant bruising and swelling at the front of the thigh. There will also be significant loss of strength and range of motion when trying to extend the knee.

In some cases, a lump may appear at the injury site. This may be the severed muscle that has coiled back upon itself inside the thigh.

Those experiencing some or all of the above symptoms should consult a doctor for medical advice.

Treatment Of Quadriceps Strains

Non Invasive Treatment

Unless your quadriceps strain is grade III in severity, your doctor will likely suggest home based treatment based on rest, icing, compression and elevation. He or she will suggest:

  • Resting the injured leg by avoiding running or jumping activity. To take even more pressure off the leg, the doctor may suggest using crutches for a period;
  • Applying ice or a cold compress to your injured quadriceps. Do this for 20-30 minutes at a time and at intervals of 2-3 hours. Avoid allowing the ice or cold compress to come into direct contact with your naked skin. This will reduce blood flow to the area and thus ease any swelling you may be experiencing. It will also help to reduce pain;
  • Applying compression to the injured muscles by wearing a thigh compression sleeve or using a tensor bandage;
  • Elevating your injured quads above heart level to promote drainage of lymph fluids and stale blood flow from the area.
  • For further control of pain and swelling, use an anti inflammatory medication like Advil;
  • Commence physical therapy exercises to gently stretch and strengthen your quad muscles;
  • Avoid resuming normal activities until you are again pain free .

The recovery time for a grade I or II strain can range from a few weeks up to around 3 months. The exact period will of course depend on the severity of the injury and well as your physical condition.

Surgical Treatment

The above home based treatments are unlikley to be adequate to treat a grade III quadriceps strain. If you have experienced complete severance of a quad muscle, you will need to undergo surgery to correct the damage.

After surgery, you will need to undergo extensive physical therapy to prepare your repaired quad muscles for a return to normal activity.

The recovery period for a grade III strain can be considerably longer than that for grades I and II. You should expect to need as long as 6 months before you are ready to resume normal activities

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