Quadriceps Strain

From DeLee JC, Drez D Jr.: Orthopaedic Sports Medicine:
Principles and Practice. Philadelphia, WB Saunders, 1994, p. 1103.

Description
Quadriceps strain is inflammation and pain in the front of the thigh along the quadriceps muscles. There are four muscles that comprise the quadriceps muscle group, going from the hip across the knee to the leg. This muscle group is important for straightening your knee and bending your hip and is used for running and jumping. This is usually a grade 1 or 2 strain of the muscle-tendon unit. A grade 1 strain is a mild strain. There is a slight pull without obvious tearing (it is microscopic tearing). There is no loss of strength, and the muscle-tendon unit is the correct length. A grade 2 strain is a moderate strain. There is tearing of fibers within the substance of the muscle or tendon or where the tendon meets the bone. The length of the muscle-tendon-bone unit is increased, and there is decreased strength. A grade 3 strain is a complete rupture of the tendon.

Common Signs and Symptoms

Pain, tenderness, swelling, warmth or redness over the quadriceps muscles at the front of the thigh
Pain that is worse during and after strenuous activity
Muscle spasm in the thigh
Pain or weakness with running, jumping, or straightening the knee against resistance
Crepitation (a crackling sound) when the tendon is moved or touched
Bruising in the thigh 48 hours following the injury
Loss of fullness of the muscle or bulging within the area of muscle with complete rupture

Treatment
Initial treatment consists of ice to relieve the pain, stretching and strengthening exercises (particularly bending the knee), and modification of the activity that caused the problem. These all can be carried out at home, although referral to a physical therapist or athletic trainer for further evaluation and treatment may be helpful. An elastic bandage or neoprene (wetsuit material) sleeve may help reduce swelling and reduce symptoms. If the strain is severe and the athlete is limping, crutches may be recommended for the first 24 to 72 hours, until the pain and inflammation settle down.