An injury to the largest muscle group of the thigh, known as the quadriceps, can be a real game changer for a serious athlete or weekend warrior alike. The quadriceps are actually a group of four muscles that run down the thigh, the rectus femoris in the front, with the vastus lateralis and the vastus medialis on either side and the vastus intermedius deep in the middle. An injury to these muscles usually occurs when they haven’t been warmed up properly before exercise, and the person jumps, kicks or sprints. Another way the muscles can be injured is by blunt trauma or force, like being hit by a baseball or bat.
When these muscles are stretched or torn, we call it a strain. Strains are graded by severity and the treatment for each varies. As soon as the injury happens, cold packs and compression should be applied to reduce swelling and internal bleeding. All but the most minimal strains should be evaluated by an OSC Orthopaedic physician for severity and appropriate treatment.
Grade 1 – The patient will have felt a pull or twinge during injury, but should be able to straighten the knee. Walking or running will be uncomfortable, but not impossible. Swelling or discoloration will be minimal.
PRICE Protocol should be employed for the first 24 hours. Protection, Rest, Ice, Compression, and Elevation. Ice should be used intermittently every 10-15 minutes per hour for the first 48 hours. Aleve may be taken for pain and to reduce inflammation. The patient will recover after a few weeks of modified activity. Physical Therapy may be needed to regain full range of motion and strength.
Grade 2 – The patient will have felt a significant pain during injury, and it will be painful to straighten the knee. Walking will be very uncomfortable, running impossible. Some swelling and bruising will occur. Pressing on the quadriceps will cause pain.
PRICE (Protection, Rest, Ice, Compression, and Elevation) Protocol should be employed for the first 48 hours. Ice should be used intermittently every 10-15 minutes per hour for the first 48 hours. Aleve may be taken for pain and to reduce inflammation. It is important to keep the leg elevated and to wear a compression bandage during the acute stage to help with swelling.
When the patient comes to OSC for evaluation, x-rays will be ordered to see if there is a fracture. If not, Physical Therapy may be prescribed to build strength and to rehabilitate the injured muscle. Sports Massage may also be helpful. A knee immobilizer might also be recommended for a few weeks and modification of activities for at least a month to allow for healing. Crutches may also be necessary for ambulation. After the first 48 hours, the patient may alternate hot and cold therapy to see if that brings pain relief.
Grade 3 – The patient will have felt a severe and sharp pain during injury, will not be able to straighten the knee and will not be able to walk without assistance or crutches. Pronounced swelling or bruising is likely and a bulge in the muscle may form due to muscle contractions. Depending on the severity of the injury, the OSC Specialist will determine the appropriate course of treatment and whether surgery is needed. If there is a partial tendon tear, surgery may be the best course of action. If the tear is complete, surgery will be required for normal muscle function.
PRICE (Protection, Rest, Ice, Compression, and Elevation) Protocol should be employed immediately and medical attention should be sought. Ice should be used intermittently every 10-15 minutes per hour for the first 48 hours. Aleve may be taken for pain and to reduce inflammation.
If surgery is performed, a knee immobilizer may be placed on the leg to allow for healing post-operatively. Physical Therapy will be prescribed to help the patient regain full range of motion and strength in the leg. Healing will take several months or longer and the patient will not be able to return to sports for at least 4 months.