Quad strain – will you be left kicking yourself?

What causes a Quad strain?

The quadriceps (otherwise known as quads) are a group of powerful muscles at the front of your thigh (or upper leg).  The quadriceps are made up of four muscles, hence the name “quads”, namely biceps femoris, vastus medialis, vastus intermedius and vastus lateralis.  These muscles arise from the front of the hip and upper femur (or thigh bone) and insert into the lower femur, knee cap and via the patella tendon into the upper tibia (or shin bone).  The quadriceps main role is being responsible for knee extension, however one of the muscles, biceps femoris, can also act as a hip flexor. So how do quad strains happen?

Injury commonly occurs in the muscle although it can occur in the tendon. Strains can range from mild to very severe and in extreme case even rupture of the biceps femoris off the hip. Quad strains often occur during rapid or powerful knee extension such as kicking a football or taking off when jumping or sprinting.

Quad strain risk factors

Quad tears can happen to anyone, but you are more likely to do so if you:

  • Are older than 30 years of age.
  • Are a deconditioned athlete.
  • Have an inadequate warm up period for your chosen sport.
  • Are an infrequent sporting participant, particularly without training.
  • Have muscle tightness, fatigue or imbalances.
  • Have a poor technique that puts extra strain on your quadriceps.
  • Have a history of a previous thigh strain without adequate rehabilitation.

What are the symptoms of a Quad strain?

  • Often you feel a distinct pop/pull with sharp pain/cramp in your anterior thigh
  • This eventually settles down into a constant ache
  • Pain is located on the front of the thigh, between the knee and the hip
  • Pain during activities which engage the effected side by contracting the quad – anywhere from walking to squatting can be effected (depending on severity)
  • Pain on stretching the quad (bending your knee behind you)
  • May have some swelling, tenderness and/or bruising.
  • An audible “pop” or snapping sensation at the time of the injury, which may indicate a tear or rupture.

How is a Quad Strain Diagnosed? 

  • Grade 1 quad strain (1-3 weeks)

With a grade 1 strain, there will be tightness on the front of the leg and it may cause a minor limp. Awareness of quad/thigh discomfort and an inability to run, kick, jump or push off with any power or speed. Will commonly be mild pain and inflammation, may get some minor bruising. Bending your knee will cause mild pain and irritation

  • Grade 2 (4-8 weeks)

With a grade 2 strain the limp will be much more noticeable and pain with any power movement (squat/lunge/walking upstairs) will be present, with feeling of twinges or cramping feelings with activity. Inflammation will be increased and bruising may pool around the knee.

  • Grade 3 (6 – 12 Weeks)

A grade 3 calf strain is a severe injury involving a complete tear to half or all of the calf muscle. Crutches or even a moon boot may be required to enable walking due to severe pain and weakness. Immediate swelling and bruising will be present within 24 hours.

Quad Strain treatment

  • If you suspect you’ve torn your quad the first thing to do is to initiate the PEACE & LOVE protocol.
  • This involves weight bearing if tolerated, severe quad strains may require crutches for ambulation
  • If tolerated take short frequent walks whilst wearing a compression bandage.
  • Get in to see one of our excellent osteopaths for assessment, treatment and rehabilitation ASAP.
  • In the initial occurrence avoid HARM – this is heat, alcohol, running and direct massage

How can an Osteopath help?

Your Osteopathic treatment will assess the severity of the injury and then aim to :

  • Reduce pain and inflammation.
  • Protect your injury.
  • Normalise joint range of motion.
  • Strengthen your knee and leg, especially quadriceps, hamstrings and gluteals.
  • Monitor patellofemoral pain.
  • Normalise your muscle lengths and neurodynamics.
  • Improve proprioception, agility and balance.
  • Improve your technique and function, eg walking, running, squatting, hopping, landing and kicking.
  • Minimise the chance of recurrence or re-injury.

Dr. Cameron Bayliss

B Hlth Sc, B App Sc (Osteopathy)

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