A forceful stretch or tear of the muscle or tendon in a weight-bearing muscle such as the quadriceps is painful and difficult to rest. The quadriceps are involved in supporting the hip and knee to hold the weight of it. A quadriceps strain can result from a forceful contraction of the quadriceps or unusual stress placed on the muscles. As with other strains, it is graded 1 through 3, with 3 being the most severe tear.
A strain may occur in any of the quadriceps muscles but the rectus femoral is most commonly injured. The force generated in activities such as sprinting, jumping and weight training may cause micro-tears in the muscle. When the muscle is stretched forcefully under a load as in high-impact sports like football and hockey it may also pull away from the muscle-tendon junction or bony attachment or tear completely.
Cause of injury
Forceful contraction or stretch of the quadriceps.
Signs and symptoms
Grade 1: Mildly tender and painful. Little or no swelling. Full muscular strength.
Grade 2: More marked pain and tenderness. Moderate swelling and possible bruising. Noticeable loss of strength.
Grade 3 (full tear): Extreme pain. Deformity, swelling and bruising. Inability to contract the muscle.
Complications if left unattended
A grade 1 or 2 tear left unattended can continue to tear and become worse. A grade 3 tear left untreated can result in loss of mobility and a severe loss of flexibility in the muscle.
Immediate treatment
RICER regimen. Anti-inflammatory medication. Immobilization in severe cases. Then heat and massage to promote blood flow and healing.
Rehabilitation and prevention
After the required rest period, activities should be resumed cautiously. Avoid activities that cause pain. Stretching and strengthening of the quadriceps will be necessary. Ensuring a balance of strength between the quadriceps and hamstrings is important to prevent a strain. Proper warm-up techniques must be observed to prevent strains and gradually increasing intensity will help as well.
Long-term prognosis
Quadriceps strains seldom result in long-term pain or disability. Surgery is only needed in rare cases where a complete tear does not respond to immobilization and rest.