What is the quadriceps muscle and what causes it to strain?
The quadriceps is a group of four muscles in the front of the thigh; the vastus medialis, the rectus femoris, vastus intermedius and the vastus lateralis. The function of the quadriceps muscle is to straighten the knee, help maintain the position of the kneecap and control the rate of knee flexion (bending).
A common cause of quadriceps muscle strains is weakness of the quadriceps. Additionally, when the quadriceps is trying to extend (straighten) the knee and an external force is trying to flex the knee, the muscle can stretch or tear. This can be seen in running or jumping sports such as football, basketball and skiing. Muscles work in pairs and the quadriceps and hamstring muscles work together to flex and extend the leg. Quadriceps muscle strains occur in runners, since running develops the quadriceps more than the hamstrings, which can lead to an abnormal imbalance. Quadriceps strains can affect other individuals, but most often occur during activities requiring a burst of speed and rapid stopping and starting.
Symptoms:
- Dull ache in the front of the thigh in a mild strain
- Possible swelling or bruising in the front of the thigh
- Severe pain and bruising with higher grade strains
Diagnosis: Your physician will take a detailed history and do a thorough clinical exam. The diagnosis is generally readily made on exam.
Treatment: Quadriceps strains are classified as grade 1, 2, or 3, depending on the severity.
Grade 1 quadriceps strain:
- Minor tear within the muscle
- Tightness in the back of the thigh
- Minimal discomfort while walking
- Possible swelling
Grade 2 quadriceps strain:
- Partial tear in the muscle
- Possible limp when walking
- Pressure increases pain
- Flexing knee against resistance causes pain
- Sudden twinges of pain during activity
- Range of motion may be impaired
Grade 3 quadriceps strain or tear:
- Complete rupture of the quadriceps muscle
- Impaired mobility; may need crutches initially
- Severe pain; particularly when trying to flex knee
- Swelling
Immediate treatment of a quadriceps strain is:
Rest the affected extremity and avoid strenuous activity until pain and swelling have subsided.
Apply ice packs to the affected thigh over a thin layer of cloth for 20 minutes, 2-3 times a day for the first 48 hours. Once activity is resumed, ice the muscle before and after exercise to reduce potential swelling.
Applying an ace wrap or compression on the affected extremity can decrease swelling and provide support.
Elevate the affected extremity above the level of the heart on a pillow.
Non-steroidal, anti-inflammatory medication such as Advil or Aleve can be helpful in reducing swelling and controlling pain. Referrals to physical therapy if appropriate Gradual return to activity under the direction of your doctor with the incorporation of a stretching and strengthening program.
Prevention of quadriceps muscle strains:
- Stretching before and after activity
- Strengthening program incorporating quad extensions and squats
- Cross-training with biking, elliptical and stair stepper
