Quadriceps Strains

Quadriceps Strains

A strain is a tear in the muscle, in this case the quadriceps. It is usually in the centre of the thigh and can vary in size. If the strain is superficial you may be able to feel it. The size of the strain (grade I, II or III) usually correlates to the intensity of the pain and the function of the muscle. Quadriceps strains occur when the force and possibly the velocity of the contraction exceed the muscles’ ability to resist that force.

Grading

To keep it simple we use the following guidelines to grade a muscle strain.

  • Grade 1: You have torn a few muscle fibres.  You may have some pain but can usually maintain normal activities.
  • Grade 2: More muscle fibres are torn. There can be moderate swelling including bruising, it is commonly tender to touch and it becomes difficult to use the muscle or limb.
  • Grade 3: a large portion of the muscle is torn, in some case the length of the muscle belly.  Severe bruising and swelling occurs and movement is limited. On contraction of the muscle a bulge will often appear.

Common causes of quadriceps strain

Quad strains are very common in sports that involve sudden bursts of speed such as hockey, AFL, soccer and rugby These injuries are also prevalent in sports such as kickboxing and karate. The most commonly injured leg is the dominant kicking leg.

Some other facts:

  • In soccer, quadriceps strains are more likely to occur during matches than in training. In AFL it to be the reverse – possibly due to high-frequency kicking during training sessions.
  • If you have sustained a quadriceps strain in the past you are likely to take 30 % longer to return to sport than someone who sustains one for the first time.
  • In AFL more quad strains occur on drier, harder grounds.
  • Quadriceps strains are less frequent in soccer than in AFL
  • 60% of quadriceps strains occur on the dominant leg (preferred kicking leg)
  • They constitute almost one-third of all time-loss injuries in men’s professional football and 92% of all injuries affect the 4 big muscle groups in the lower limbs. The quadriceps take up 19% of this. (1)

Management of quadriceps strains

Stop what you were doing as soon as you can and over the next 48-72 hours use the RICER rule (Rest, Ice, Compress, Elevate and Referral). This is all to minimise the swelling and prevent further injury. Apply ice for 15 minutes on/off. You can safely repeat this process 3-5 times. The best way to get compression over the quadriceps (and most other body parts) is to use an appropriate compression brace. Initially, you can use a crepe bandage or similar and wind it around the thigh working upwards and covering the affected area only. Elevate the leg so that gravity will allow draining towards the centre of the body.

You should always have your muscle and joint strains and sprains checked out by a professional health practitioner.

In conjunction with RICER you should also “DO NO HARM” – Apply NO Heat, Drink NO Alcohol and take NO Anti-inflammatories, No Running and NO Massage to the injured area.

Prevention is better than cure!

In many cases you have the power to significantly reduces your risk of sustaining a quadriceps strain.   With a little planning you can prepare your muscles to condition them before the new sports season starts.

If you know your first match is in April but you haven’t kicked a ball since September you will be well advised to start  a specific drills and strengthening workout to gradually built up your tolerance and loading ability.

To get the right program it is important to measure your baseline fitness and strength.

Focus Physiotherapy will be able to recommend a suitable program for you.  Expect improvements to take between six to eight weeks as muscle building takes time.

(1) Epidemiology of Muscle Injuries in Professional Football (Soccer), Jan Ekstrand, MD, PhD*, Martin H�gglund, PT, PhDand Markus Wald�n, MD, PhD

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