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Quadriceps Strain
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Quadriceps Strain

(Pulled Quadriceps)

En Español (Spanish Version)

Definition

Quadriceps strain is a partial tear of the small fibers of the muscles that make up the quadriceps group. The quadriceps are the large group of muscles in the front of the thigh. They consist of four muscles in each leg that run from the hips to the knees.

The Quadriceps Muscles

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Causes

A quadriceps strain can be caused by:

  • Stretching the quadriceps beyond the amount of tension or stress that they can withstand
  • Suddenly putting stress on the quadriceps when the muscle is not ready for the stress
  • Using the quadriceps too much on a certain day
  • A blow to the quadriceps

Risk Factors

A risk factor is something that increases your chance of getting a disease, condition, or injury.

  • Sports that require bursts of speed, such as:
    • Running
    • Hurdles
    • Long jump
    • Basketball
    • Soccer
    • Football
    • Rugby
  • Fatigue
  • Tight quadriceps
  • Overexertion
  • Cold weather
  • Previous quadriceps injury

Symptoms

Symptoms include:

  • Pain and tenderness in the front of the thigh
  • Stiffness in the quadriceps
  • Weakness of the quadriceps
  • Bruising on the front of the thigh (if blood vessels are broken)
  • Popping or snapping sensation as the muscle tears (rare)

Diagnosis

The doctor will ask about your symptoms and medical history, your recent physical activity, and how the injury occurred. The doctor will also examine your thighs for:

  • Tenderness and/or bruising directly over the quadriceps
  • Pain or weakness when contracting the quadriceps, particularly against resistance

Muscle strains are graded according to their severity:

Grade1

  • Some stretching with microtearing of muscle fibers.
  • Recovery can be complete in 10-21 days.

Grade 2

  • Partial tearing of muscle fibers.
  • Recovery can take up to 1-2 months.

Grade 3

  • Complete tearing (rupture) of muscle fibers.
  • Recovery can take more than 3 months.
  • Surgery may be needed to repair the torn muscle fibers.

For severe quadriceps strains, you may have an MRI scan to see if the tearing requires surgical repair. Professional athletes sometimes have MRI scans to help predict the length of their recovery.

Treatment

Treatment depends on the severity of the strain.

Treatment usually includes:

  • Rest—Do not do activities that cause pain, such as running, jumping and weightlifting using the thigh muscles. If normal walking hurts, shorten your stride. Do not play sports until the pain is gone and your doctor has given you permission.
  • Cold—Apply ice or a cold pack to the quadriceps area for 15 to 20 minutes, 4 times a day for several days after the injury. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
  • Pain relief medications—Take aspirin, ibuprofen (Advil, Motrin), or acetaminophen (Tylenol) to help relieve pain. Ask your doctor if you have any questions about using these medications. If you still have tenderness in the quadriceps while taking these drugs, do not return to physical activity. First, check with your doctor before returning to play.
  • Compression—Wear an elastic compression bandage (e.g., Ace bandage) around your thigh to prevent additional swelling. Be careful not to wrap the bandage too tightly.
  • Elevation—Keep your leg higher than your heart as much as possible for the first 24 hours or so to minimize swelling.
  • Heat—Use heat only when you are returning to physical activity. Then use it before stretching or getting ready to play sports.
  • Stretching—When the acute pain is gone, start gentle stretching exercises as recommended by a health care professional. Stay within pain limits. Hold each stretch for about 10 seconds and repeat 6 times.
  • Strengthening—Begin strengthening exercises for your quadriceps as recommended by a health care professional.

Prevention

To reduce the chance that you will strain your quadriceps:

  • Keep your quadriceps muscles strong so they can absorb the energy of sudden physical stress.
  • After a short warm-up period, stretch out your quadriceps.
  • Learn the proper technique for exercise and sporting activities. This will decrease stress on all your muscles, including your quadriceps.

RESOURCES:

American Academy of Family Physicians
http://www.aafp.org

American Council on Exercise
http://www.acefitness.org

CANADIAN RESOURCES:

Canadian Family Physician
http://www.cfpc.ca/cfp/

Physical Therapy
www.physicaltherapy.ca

References:

American Academy of Orthopaedic Surgeons.

American Orthopaedic Society for Sports Medicine.

Exercise and Sports Sciences . Lippincott Williams and Wilkins; 2000.

Nicholas Institute of Sports Medicine and Athletic Trauma.

Sports Injuries: Basic Principles of Prevention and Care . Blackwell Scientific Publications; 1993.



Last reviewed January 2008 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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