Thigh Strain

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Young lean African American male athlete sits on grass clutching injured leg and hamstring while in excruciating pain, possibly with thigh strain injury

A thigh strain is an injury caused by damage (overstretching, tearing or a complete rupture) to the thigh muscles. These may be any of the quadricep, hamstring or adductor muscle groups of the thigh.

Risk factors for this injury are muscle tightness, muscle fatigue, incorrect exercise technique and inadequate warming up. A previous thigh strain can also increase the risk of another occurrence of the injury.

Typical symptoms of a  thigh muscle strain are thigh pain while walking, going up or down stairs. Pain may also be experienced while sitting or performing any other activity that involves flexing the quadricep muscles.

There will also be a “pulling” sensation in the thigh together with swelling, bruising or thigh tenderness. If the injury is severe, the patient may experience difficulty walking or even standing.

Doctors may diagnose a thigh strain by examining and palpitating (feeling) the thigh. They may also ask the patient about his or her medical history and how the injury occurred. In some cases, the doctor may request a magnetic resonance imaging (or other) scan. This will help with the assessment of the extent of soft tissue and possibly bone damage.

Most mild or moderate thigh strains are treatable at home by resting and icing the thigh. However, severe strains in which the muscle is completely severed will usually require surgery to correct the damage.

Types Of Thigh Strain

The three main muscle groups of the thigh are:

  • The hamstring muscles at the rear (posterior) of the thigh. Damage to this muscle group comes under the heading of a hamstring strain injury;
  • The quadriceps muscle at the front (anterior) side of the thigh. Damage to this muscle group is known as a quadriceps strain injury; and
  • The adductor muscles of the inner thigh. Adductor (or groin) strains are caused by damage to these muscles due to overstretching or tearing.

The hamstring, quadriceps and adductor muscle groups all cross both the hip and knee joints. As a  result, they play a role in the operation of both joints. That makes them more susceptible to strains than other muscle groups that cross only one joint.

Thigh Strain Symptoms

In the previous section, we explained that thigh strains can be hamstring, quadriceps or adductor strains.

In addition, and as with other muscle injuries, strains are graded as to their degree of severity. The various grades of severity, together with the corresponding symptoms, are

  • Grade I (or mild) strains involving only mild overstretching of the muscle, but no tearing. The patient may experience a slight twinge in the thigh and some tightness but is unlikely to experience significant pain. There may be some tenderness in the thigh but no signidficant swelling or bruising.

Where movement is concerned, the individual may experience marginal difficulty in walking or running. However, these actions will still be possible. This type of muscle strain is commonly referred to as a “pulled muscle”.

  • Grade II (or moderate) strains, in which the muscle is partially, but not completely, torn. Typically, the recipient of such an injury will experience a sharp pain at the time of the injury. The pain will continue afterwards, and will be significant enough to interfere with the ability to walk and (moreso) run.

Recipients of this injury may also report hearing or sensing a “pop” or “snap” at the time the injury occurs.

Some slight swelling and contusions may be present over the site of the injury.

  • Grade III (or severe) strains in which the muscle is completely severed. This frequently happens at the junction with the tendon that connects the muscle with an adjacent bone.

Patients will likely experience a snapping or popping sound or sensation from the thigh at the time the injury occurs. There will also be intense pain from the thigh at that instant. That pain will continue and be severe enough to make walking or running difficult or impossible. In addition, there may be significant swelling, bruising and contusions over the site of the injury.

Individuals who experience a grade III strain may also notice the appearance of a lump in the painful area. This may be the result of the severed muscle recoiling on itself within the site of the injury.

Treatment Of A Thigh Strain

Non Surgical Treatment

Doctors will opt to treat most grade I or II thigh strains conservatively. In most cases, the treatment plan will be based on the R.I.C.E. protocol:

  • Rest the injured muscle by temporarily avoiding activities that require running or jumping. By allowing the injured muscles to rest, you are allowing them a chance to repair the damage naturally. To allow them an even greater opportunity to recover, consider using crutches to keep the body weight off the thigh;
  • Apply Ice to the injured area. A cold compress can be used in lieu of the ice. Avoid direct contact between the ice or cold compress and the skin, as that may cause skin damage. Instead, wrap the ice or cold compress in a wet towel before applying it to the skin.

For optimal results, apply the ice/cold compress for periods of 20-30 minutes at a time. Do this at intervals of 2-3 hours.

The ice or cold compress treatment will help by constricting the blood vessels and reducing blood flow to the injured muscles. That in turn will help to reduce pain

By “crowding out” the pain signals to the brain, the ice/cold compress will also help with pain reduction.

  • Whenever possible, Elevate the thigh above heart level (e.g. when sitting or lying down). This will help drain blood and lymphatic fluids away from the injury and reduce pain and inflammation.
  • For additional pain control, consider a pain relief medication such as Tylenol. If you need to control both pain and swelling, you can try an anti inflammatory medication such as Advil;

As an important part of the healing process, your doctor may suggest physical therapy exercises. These will help strengthen your thigh muscles and improve knee and hip range of motion.

Avoid returning to sports or other strenuous activity until you are again pain free. You should also wait until your normal range of motion has returned.

Surgical Treatment

Non surgical treatment approaches such as described above will unfortunately not suffice for a grade III thigh strain. Instead, you will need to consider surgery to correct the soft tissue (and possibly bone) damage from such a strain. Your doctors will be able to lay out the various surgical approaches and make a recommendation.

As part of your recovery from surgery, you will need to undergo a program of physical therapy. As with non surgical treatment, these exercises will help return the thigh muscles to their normal condition.

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