If you’re an athlete or fitness enthusiast, it’s likely you’ve encountered a pulled muscle at some point. A pulled quadriceps is less common than other injuries, but often occurs in middle-aged individuals who play sports that involve running and jumping.
Quadriceps strains can range from a minor ache to a major setback, depending on the severity of the strain or tear. A pulled quad is often treatable with some rest, ice, and medication.
The quadriceps are the group of four muscles on the front of the thigh that act to straighten the leg at the knee. Injuries can range from a grade 1 (mild) strain to a grade 3 (severe) tear.
- loss of strength
- difficulty moving the leg
Inflammatory stage: First 48 to 72 hours
After an injury, chemicals released from the damaged tissue cause blood vessels to open and leak blood and fluid into the surrounding area. This is the primary reason for swelling and pain immediately after an injury.
The American Academy of Orthopaedic Surgeons (AAOS) recommends the R.I.C.E. principle (rest, ice, compress, elevate) outlined below for healing during the initial recovery phase. Anti-inflammatory medications such as aspirin, acetaminophen, ibuprofen, and naproxen may provide some much-needed pain relief.
If you experience a sudden pain in the quad during exercise, it’s best to stop what you’re doing and seek help. Avoid all activities that involve lower body strengthening, such as squats, lunges, running, or jumping activities.
Apply ice or cold packs for 15 minutes multiple times per day on the area of pain. Always wrap the ice in a towel to avoid direct contact with the skin.
If the area becomes swollen or red, it’s best to apply compression to control the swelling. Try using an elastic bandage around the swollen area, or use a compression sleeve that covers the top portion of the leg.
Elevate your leg when possible to help decrease swelling and pain. You can do this by propping your leg up on a pillow while lying in bed or on the couch. The goal is to get the injured leg above your heart so that gravity can assist with moving fluid away from the site of injury.
Repair phase: 72 hours to 6 weeks
After the initial inflammatory response occurs, it’s time for your tissues to start rebuilding. Full recovery can take up to six weeks or more. For a mild strain or sprain, most people feel better after a week or two of rest. You’ll know your quad is healed when you no longer have pain and can move your leg through its full range of motion.
During this time, a gradual rehabilitation program is beneficial. Before stretching, apply a moist heat pack to the area for 15 to 20 minutes to warm up the muscles. When warm, you can do some gentle stretching of the legs and hips.
Try doing a quadriceps stretch by lying on your belly and pulling your foot up toward your buttocks until you feel a stretch. Gradually increase the tension, being careful to avoid sudden movements. Never stretch past the point of pain. Repeat this two to three times per day.
You can also incorporate light strengthening activities such as seated leg extensions or wall squats. This will help strengthen your injured leg and prevent injury once you return to full activity. Always check with your doctor or physical therapist before doing any stretching or strengthening exercises.
You’ll know you are ready to resume playing sports once you no longer have pain and can move your leg with ease. The key to preventing injuries is to return to your activities slowly and not strain your muscle by doing too much, too fast.
If you’re returning to activities such as running or weightlifting, start off slowly and work your way up to your previous level by increasing your distance or weight gradually. The AAOS recommends that the strength of your injured leg be at least 85 percent of your uninjured leg to return to competitive sport.
You’re more likely to strain your quadriceps again after an initial injury. Cold muscles are more likely to sustain an injury. Therefore, the best way to prevent damage is to perform a full warmup before any exercise or stretching. Always allow for a longer warmup when exercising in cold weather.
Lastly, if you feel tightness in your quadriceps while exercising, always stop what you’re doing and rest. Don’t increase the intensity, frequency, or duration of your activity too rapidly and be sure to build in rest because overuse injuries are more likely to occur. This will help prevent another injury.
Quadriceps injuries can range from mild to severe, but they usually heal on their own. Be sure to give your body adequate time to rest. Follow the above treatment tips to ensure a fast recovery and prevent re-injury.
When should you see a doctor if you think your injury is severe?
The National Institute of Arthritis and Musculoskeletal and Skin Disease recommends contacting your doctor immediately to make sure you are getting the right treatment. They can refer you to a physical therapist who can design an appropriate stretching and strengthening program. The American College of Sports Medicine generally recommends seeking medical treatment if the pain level becomes debilitating or if you experience heavy swelling. If you cannot bear weight on your leg, you should also seek immediate attention. When in doubt, it is best to seek medical advice to avoid further damage.Peggy Pletcher, MS, RD, LD, CDEAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.