Everything You Need to Know About Quadriceps Strains

By Jim Brown

Overview
The quadriceps are a group of four muscles on the front of the upper thigh that work together with the hamstrings (on the back of the upper thigh) to extend and bend the leg. Having strong, powerful quadriceps is necessary for athletes in high-speed sports such as track and field, football, basketball and soccer. Injuries to the quads are among the most common (and treatable) among athletes at all levels.

A quadriceps strain involves a partial or complete tear of one of those four muscles or their tendons when they're stretched beyond their normal limits.

How Strained Quadriceps Happens
Quadriceps muscles are most often strained when an athlete is trying to accelerate. The quadriceps muscles are placed under more force than they can withstand, and the muscle fibers, tendons, or both begin to tear away from the bone. When the muscles are fatigued, overused, or not adequately warmed up, they're more susceptible to strain. An imbalance between weak quadriceps and stronger hamstrings can also cause the injury, a condition that is common among runners. Tight quads can also cause the same problem. When the quadriceps are hit with a direct blow, like when being tackled or blocked in football or checked in hockey, they’re at risk of injury.

Strained Quadriceps by the Numbers
Even though quadriceps strains (also referred to as “pulls”) are common among athletes, there’s a limited amount of sport-specific research regarding their frequency. A one-year study conducted at the United States Military Academy at West Point produced the following numbers:

4.7: Percentage of pulled quads among karate athletes.
2.3: Percentage of pulled quads among judo athletes.
1.6: Percentage of pulled quads among football players.
1: Percentage of pulled quads among all other athletes.

Who’s at Risk for Strained Quadriceps
Athletes who need a burst of speed are at the highest risk. This includes runners, sprinters, hurdlers, jumpers and basketball players. Soccer, football, rugby, and lacrosse players are also at high risk. Any athlete with a previous quadriceps injury is more likely to suffer the same injury again.

Symptoms
• Pain when flexing, stretching or using the thigh muscles to move.
• Muscle spasms
• Swelling
• Bruising on the front of thigh if blood vessels are broken.
• Loss of leg strength.
• Crackling sensation when you push your fingers on the injured area.

Initial Treatment
• Rest, and avoid activities that require lower-leg strength and power.
• Apply ice or cold packs for 15-20 minutes, three to four times a day for the first 48-72 hours.
• Apply moist heat after the first 48-72 hours for 15-20 minutes, three to four times a day.
• Use an elastic wrap or bandage around the area to minimize swelling.
• Use a pillow or cushion to elevate the affected leg as much as possible during the day and while   sleeping at night.
• Aspirin, acetaminophen, ibuprofen, and naproxen may relieve pain.

Comeback Strategy
Mild quad strains usually heal within 10 days. Moderate strains take 10 days to six weeks, and severe strains require three months or longer for recovery. Your return should be based on the absence of symptoms and the presence of normal leg strength and range of motion, not a certain number of days, weeks or months. Use these tips to make a comeback:
• Go through each movement required in your sport without pain before resuming normal training
  and competition.
• Use heat on the area before an exercise session.
• If running is part of your comeback program, don't run at full speed.
• If you're running, avoid sudden stops until there are no symptoms and you have regained full   strength and range of motion.
• Cross-train in sports that don’t place a heavy demand on the quadriceps (upper body strength   training, easy lap swimming, soft-tossing a baseball, hitting off a tee, etc.).
• Apply ice packs for 15-20 minutes after working out.

Prehab
Incorporate these prehab exercises into your comeback routine:
1. Foam Roll - Quadriceps / Hip Flexor
2. Foam Roll - Hamstrings
3. Glute Bridge - Padded

How to Avoid Quadriceps Strains
You're more likely to sustain a strained quadriceps if you've had a previous injury to the same muscle group. Follow these guidelines if you feel as though you've strained your quadriceps muscle.
• Stop exercising if you feel tightness in the quadriceps (tightness may develop before the actual tear   happens).
• Do not increase the intensity, frequency or duration of exercise more than 10 percent a week.
• Allow for more warm-up time when exercising in cold weather.

Movement Prep
Incorporate these Movement Prep exercises into your warm-up routine to help reduce your risk for injury and prepare your body for training:
1. Heel to Butt - Moving Forward
2. Rope Stretch Quadriceps
3. Quad / Hip Flexor Stretch
4. Forward Lunge Elbow to Instep

Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.