Quadriceps StrainsQuadriceps Strains

Predisposing FactorsPredisposing Factors

Contact SportsContact SportsAny cardiovascular problem that leads to Any cardiovascular problem that leads to decreased circulationdecreased circulationObesityObesityPoor nutritionPoor nutritionPrevious thigh injuryPrevious thigh injuryPoor muscle conditioningPoor muscle conditioningMuscle fatigueMuscle fatigue

Mechanism of injuryMechanism of injury

Prolonged overuseProlonged overuse

Violent single blowViolent single blow

Tension forces on the quad Tension forces on the quad muscles causing an muscles causing an overstretchoverstretch

Signs and SymptomsSigns and Symptoms

Pain with knee extension and passive stretchPain with knee extension and passive stretch

Muscle spasmMuscle spasm

SwellingSwelling

Loss of strength Loss of strength

CrepitationCrepitation

Point tenderness over injury sitePoint tenderness over injury site

EcchymosisEcchymosis

Defect in the muscle (third degree)Defect in the muscle (third degree)

Examination and EvaluationExamination and Evaluation

PalpationPalpation– Rectus femorisRectus femoris– Vastus lateralisVastus lateralis– Vastus medialisVastus medialis– Vastus intermediusVastus intermedius

Examination and EvaluationExamination and Evaluation

Muscle TestingMuscle Testing– A, RROM Knee ExtensionA, RROM Knee Extension– A, RROM Hip FlexionA, RROM Hip Flexion– Passive stretch quadriceps Passive stretch quadriceps

muscle (combined knee muscle (combined knee flexion and hip extension)flexion and hip extension)

ClassificationsClassifications

Mild (Grade 1) – Slightly pulled without Mild (Grade 1) – Slightly pulled without tearing of muscle tendon or fibers. No loss tearing of muscle tendon or fibers. No loss of strengthof strengthModerate (Grade 2) – Tearing of fibers in Moderate (Grade 2) – Tearing of fibers in the muscle, tendon, or attachment to the the muscle, tendon, or attachment to the bone. Strength is diminished.bone. Strength is diminished.Severe (Grade 3) – Rupture of muscle-Severe (Grade 3) – Rupture of muscle-tendon-bone attachment with separation of tendon-bone attachment with separation of fibers. Requires surgical repairfibers. Requires surgical repair

Referral/Diagnostic ProcedureReferral/Diagnostic Procedure

Orthopedic Orthopedic surgeon – surgeon –

for third degreefor third degree..

Treatment and managementTreatment and management

Cryotherapy – Cryotherapy – knee flexed positonknee flexed positon

Cold whirlpoolCold whirlpool

NSAIDSNSAIDS

UltrasoundUltrasound

MassageMassage

RehabilitationRehabilitation

StretchingStretching

Isometric muscle Isometric muscle contraction – Quad contraction – Quad setssets

Straight leg raisesStraight leg raises

Knee extensionsKnee extensions

Abduction exercisesAbduction exercises

Adduction exercisesAdduction exercises

PNFPNF

Protection and Return to Protection and Return to Competition FactorsCompetition Factors

Sport specific strength and Sport specific strength and conditioning programconditioning programWarm-up and cool-downWarm-up and cool-downProtective equipment such Protective equipment such as thigh padsas thigh padsNeoprene sleeve for Neoprene sleeve for compression and supportcompression and support

For More InformationFor More Information

http://www.http://www.injuryupdateinjuryupdate.com.au/quadriceps_strain..com.au/quadriceps_strain.htmhtm

http://www.http://www.sportsinjuryclinicsportsinjuryclinic.net/.net/cybertherapistcybertherapist/front//front/frontthighfrontthigh//quadstrainquadstrain..htm htm

http://www.http://www.worldorthoworldortho.com/.com/oxsportsmedoxsportsmed/chapt11.html#part5 /chapt11.html#part5

http://www.http://www.mdadvicemdadvice.com/library/sport/sport183.html .com/library/sport/sport183.html