Quadriceps Strain of the Thigh

A strain is a tear in a muscle or the tendon that attaches the muscle to bone. A quadriceps strain is a tear in the muscles on the front of the thigh (quadriceps muscles) or their tendons. The quadriceps muscles are important for straightening the knee and bending the hip. The condition is characterized by pain, inflammation, and reduced function of these muscles. Strains are classified into three categories.

  • Grade 1 strains cause pain, but the tendon is not lengthened
  • Grade 2 strains include a lengthened ligament due to the ligament being stretched or partially ruptured. With grade 2 strains there is still function, although the function may be diminished
  • Grade 3 strains are characterized by a complete tear of the tendon or muscle, and function is usually impaired

Prognosis

  • If treated properly, then quadriceps muscles strains are usually curable within 6 weeks

Possible Complications

  • Prolonged healing time, if improperly treated or re-injured
  • Recurrent symptoms that result in a chronic problem
  • Recurrence of symptoms if activity is resumed too soon

Symptoms

  • Pain, tenderness, inflammation, and/or bruising (contusion) over the quadriceps muscles
  • Pain that worsens with use of the quadriceps muscles
  • Muscle spasm in the thigh
  • Difficulty with common tasks that involve the quadriceps muscle, such as walking
  • A crackling sound (crepitation) when the tendon is moved or touched
  • Loss of fullness of the muscle or bulging within the area of muscle with complete rupture

General Treatment Considerations

Treatment initially involves the use of ice and medication to help reduce pain and inflammation. The use of strengthening and stretching exercises may help reduce pain with activity. These exercises may be performed at home or with referral to a therapist. Crutches may be recommended to allow the muscle to rest until walking can be completed without limping. Surgery is rarely necessary for this injury, but may be considered if the injury involves a grade 3 strain, or if symptoms persist for greater than 3 months despite non-surgical (conservative) treatment.

Causes

A strain occurs when a force is placed on the muscle or tendon that is greater than it can withstand. Common mechanisms of injury include:

  • Repetitive strenuous use of the quadriceps muscles. This may be due to an increase in the intensity, frequency, or duration of exercise
  • Direct trauma to the quadriceps muscles or tendons

Risk Increases With

  • Activities that involve forceful contractions of the quadriceps muscles (jumping or sprinting)
  • Contact sports (soccer or football)
  • Poor strength and flexibility
  • Failure to warm-up properly before activity
  • Previous injury to the thigh or knee

Preventive Measures

  • Warm up and stretch properly before activity
  • Allow for adequate recovery between workouts
  • Maintain physical fitness
  • Strength, flexibility, and endurance
  • Cardiovascular fitness
  • Wear properly fitted and padded protective equipment

Medication

  • If pain medication is necessary, then nonsteroidal anti-inflammatory medications, such as aspirin and ibuprofen, or other minor pain relievers, such as acetaminophen, are often recommended
  • Do not take pain medication for 7 days before surgery
  • Prescription pain relievers may be given if deemed necessary by your caregiver. Use only as directed and only as much as you need
  • Topical ointments may be of benefit
  • Corticosteroid injections may be given by your caregiver. These injections should be reserved for the most serious cases, because they may only be given a certain number of times

Heat and Cold

  • Cold treatment (icing) relieves pain and reduces inflammation. Cold treatment should be applied for 10 to 15 minutes every 2 to 3 hours for inflammation and pain and immediately after any activity that aggravates your symptoms. Use ice packs or massage the area with a piece of ice (ice massage).
  • Heat treatment may be used prior to performing the stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or soak the injury in warm water.

Range of Motion and Stretching Exercises – Quadriceps Strain

These exercises may help you when beginning to rehabilitate your injury. Your symptoms may resolve with or without further involvement from your physician, physical therapist or athletic trainer. While completing these exercises, remember:

  • Restoring tissue flexibility helps normal motion to return to the joints. This allows healthier, less painful movement and activity.
  • An effective stretch should be held for at least 30 seconds.
  • A stretch should never be painful. You should only feel a gentle lengthening or release in the stretched tissue.

Seek Medical Treatment If

  • Treatment seems to offer no benefit, or the condition worsens
  • Any medications produce adverse side effects

For more information about quadriceps strain, please call (918) 494-AOOK (2665).