What You Need to Know About a Quadriceps Strain

A quadriceps strain can significantly limit your ability to perform most daily tasks. The quads are used in every day activities such as walking, standing, and going up and down stairs. The R.I.C.E. protocol (rest, ice, compression, elevation) for this type of injury is most widely known. However, more recent research points towards introducing movement early. Learn about the difference between these protocols, recovery after quad strain, and how to help prevent strains in the future.

**This is not medical advice. Please consult your medical provider for more information.

Anatomy of the Quadriceps

The quadriceps muscle group is composed of 4 muscles:

• vastus laterals
• rectus femoris
• vastus medialis
• vastus intermedius

Rectus femoris is a two joint muscle, meaning it performs actions at two separate joints. This muscle extends the knee and also flexes the hip based on its attachment site on the ilium at the anterior inferior iliac spine.

The other three muscles only work to extend the knee.

Causes of Quad Strains

A quad strain can happen during an immediate injury or gradually over time from overuse.

A quadriceps injury can happen with sudden change of direction, rapid acceleration, or deceleration. This typically comes from an excessive force placed on the muscle group. Injury can also happen gradually over time due to overuse. This usually happens with repetitive movements.

Symptoms of a Quadriceps Strain

Symptoms of quad strains include:

• pain in the thigh when straightening your knee
• sharp pain in the thigh with running or jumping
• difficulty walking or going up/down stairs
• loss of range of motion of the knee
• potential bruising over the quad

How Long Does a Quad Strain Take to Heal

The time it takes for a quadriceps strain to heal is going to be determined by the degree of the injury. The severity of a muscle strain is determined by the “grade” and this helps predict the length of time needed to recover.

• Grade I: mild injury; a few number of muscle fibers torn resulting in mild pain with functional activities like walking and going up/down stairs; range of motion is usually not affected; typically heals in a few days to a couple weeks

• Grade II: moderate injury; a more significant number of muscle fibers torn resulting in moderate pain and loss of range of motion and subsequent weakness; typically takes several weeks to heal

• Grade III: severe injury; complete tearing of the muscle fibers; bruising is very likely and sometimes a gap in the muscle is observable; typically takes several months to heal

How to Prevent Quad Strains

While there is nothing you can do to completely prevent quad strains from occurring, there are proactive measures you can take to help reduce your chances of injury.

First step is to warm-up properly prior to exercise or activities. This ensures adequate blood flow to the muscles so they can work more effectively.

You’ll want to check if the muscle groups in your leg are stiff. While the quads are the obvious answer here, you’ll also want to make sure other areas move well too. This includes your proximal hip flexors, the hamstrings, and the calf. If you notice stiffness throughout these areas, working on a stretching program will be ideal.

Articles related to stretching:

• Tight Hip Flexors and How to Treat Them
• Top 5 Full Body Stretches for Outdoor Athletes
• Chronic Hamstring Stiffness? Here’s What You Need to Know

Making sure the hip flexors, quads, and hamstrings are strong will also help prevent quad strains from happening. Muscles that are strong are more resistant to stress. Bonus: strengthening these muscles can also help prevent low back injuries.

Articles related to strengthening:

• 7 Physical Therapy Strengthening Exercises for the Full Body
• Physical Therapy Exercises for Knee Pain: How to Reduce Arthritic Pain

How to Manage a Quadriceps Strain

Most people have heard of the R.I.C.E. protocol: Rest. Ice. Compression. Elevation. This protocol has been around for a long time. However, it is quite outdated.

It is now more thoroughly understood that early movement is better for speeding up recovery in injuries. A new protocol to consider would be the M.E.A.T. protocol: Movement. Exercise. Analgesics. Treatment.

While a period of rest may be needed after an acute injury, gentle movement early on flushes lymph, brings oxygen and nutrients for healing, and encourages blood flow.

Movement will incrementally increase up until a consistent exercise routine is achievable.

Use analgesics to help manage pain. This include pain medication, but also encompasses natural remedies and modalities. This can include heat, ice, magnesium, topicals, etc.

The final step in the healing process is treatment. A physical therapist can provide guided therapeutic exercise to address weaknesses and deficits to get you back as quickly and safely as possible.

How Can Physical Therapy Help

A physical therapist can prescribe graduated therapeutic exercise to get you to the next level quickly and safely.

Mentally it can be challenging navigating an injury that takes you out of the sport or activity you love. Introducing movement early can not only speed up the recovery process and help prevent the effects of immobilization, but it can also help diminish the negative effects and emotions that come up with not being able to participate in your sport or activity.

References

1. Buckwalter JA. Activity vs. rest in the treatment of bone, soft tissue and joint injuries. Iowa Orthop J. 1995;15:29-42.
2. Nash CE, Mickan SM, Del Mar CB, Glasziou PP. Resting injured limbs delays recovery: a systematic review. J Fam Pract. 2004;53(9):706-712.
3. van den Bekerom MP, Struijs PA, Blankevoort L, Welling L, van Dijk CN, Kerkhoffs GM. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?. J Athl Train. 2012;47(4):435-443. doi:10.4085/1062-6050-47.4.14

TL;DR

Learn how to manage a quad strain, how to best help speed up your recovery process, and how long it will take your quad injury to heal.