Download Quadriceps Strain

Quadriceps Strain
(Pulled Quadriceps)
by Laurie LaRusso, MS, ELS
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
© 2011 Nucleus Medical Media, Inc.
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
Experiencing a blow to the quadriceps
Doing a strenuous quadriceps activity (eg, dance)
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
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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:
Grade 1
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 or an ultrasound to see if the tearing requires surgical
repair. Professional or serious athletes sometimes need these tests to help predict the length of their recovery.
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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 weight lifting 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—Examples include aspirin, ibuprofen (Advil, Motrin), or acetaminophen (Tylenol).
Topical pain medicines (eg, creams, patches) applied to the skin are another option. 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.
If you are diagnosed with a strained quadriceps, follow your doctor's instructions.
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/
Canadian Physiotherapy Association
http://www.physiotherapy.ca/
REFERENCES:
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American Orthopaedic Society for Sports Medicine. Available at: http://www.sportsmed.org/tabs/Index.aspx .
Accessed July 15, 2009.
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Last reviewed September 2011 by Lawrence Frisch, MD, MPH
Last Updated: 9/27/2011
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