Treatments for a Quadriceps Strain

Early diagnosis and proper treatment are important to prevent a quadriceps strain from becoming chronic; it doesn't take much to change a grade 1 strain into a grade 2 strain. Injuries to the muscle belly are best managed with adherence to the conservative treatment methods, which includes modifying and/or eliminating the activities that cause tenderness or discomfort in your quadriceps area, and performing gentle strengthening and stretching once initial inflammation has gone down. Scar tissue can often develop with pulled quadriceps, where your soft tissue has pulled away from the bone. As your damaged quadriceps tissues heal this dead, fibrotic tissue will be produced instead of forming brand new healthy tissue.

This tissue adheres to your muscle fibers, tendons, ligaments, fascia, nerves, and joints causing pain and preventing them from moving properly (this limits your range of motion, flexibility and strength). Patience is required with a quadriceps strain, as it can take time to revert to your normal state. Quadriceps injuries often heal on their own but without proper rehab, they may not heal properly.

Returning to your activities too early can lead to chronic pain, which becomes much more difficult to treat afterwards. Allowing your injuries to heal properly is critical. Impatience in healing is one of the main causes that change a minor quadriceps injury into a chronic quadriceps injury.

Treatment methods and recovery time is really based on the severity of your strain, whether you have an acute or chronic strain, the type of treatment you receive, as well as your commitment to proper rehabilitation. Torn ligaments and tendons require as much time as a fracture.

Grade 1 quadriceps strains tend to take between a 1 - 3 weeks, and respond best to conservative home treatments, ultrasound and stretching/strengthening exercises.

Grade 2 quadriceps strains tend take between 3 - 8 weeks, and responds best to conservative home treatments, ultrasound and possible support aids, therapies and medications, along with a focused exercise program.

Grade 3 quadriceps strains tend to take between 2- 6 months (depending on if you require surgery), and often involve immediate medical attention, supportive aids, therapies, medication and possibly surgery, along with a regimented exercise program.

A good reference point for healing is once you've regained approximately 90% of your pre-injury strength, have 120 degrees of flexion, little quadriceps weakness, and you are pain free, you can return to your normal activities.

Serious athletes may undergo isokinetic strength testing following a muscle injury and during rehabilitation to help set up a customized exercise program. This is an indicator of recovery that tests range of knee movement; concentric, eccentric and isometric strength testing; endurance testing; quadricep: hamstring ratio (ideally 100:75); and will identify areas of weakness areas.

URICE: - This philosophy is used to decrease inflammation and relieve pain for a chronic or diagnosed pulled quadricep within the first 48 hours of a flare-up:

Ultrasound around your injured quadriceps for 5 - 10 minutes, 3 times per day. This is best accomplished with a personal, therapeutic ultrasound device.

Rest your quadriceps and leg and limit your activity; you may want to use a walking aid (cane or crutches) to prevent immediate weight bearing or a knee immobilizer (brace or cast) to prevent unnecessary movement, if severely damaged or painful.

Ice your quadriceps area 2-3 times/day for approximately 15 - 20 minutes at a time to help reduce blood flow and fluid build up in your quadriceps. Gel packs are a better option than frozen peas if possible, as they mold to your knee shape and are reusable (do not apply ice/gel packs directly on your skin, instead wrap cold compress in a wrap or cloth.

Compress your quadriceps if possible by adding light pressure to minimize swelling (make sure the compress is snug, but not too tight as it could cause numbness, tingling or more pain).

Re-freezable cold therapy compresses are excellent because they provide ice therapy, compression and a protective covering to prevent skin burn from the cold. This combination drives the cold deeper into the injured tissue than regular ice packs, and speeds the healing process. These compresses are fitted to your foot, easy to use, mess-free and re-usable.

Elevate your legs above chest level to relieve the pressure and allow any fluid to drain from your injured area.

If you do not have access to ultrasound therapy or you have experienced an acute quadriceps injury and/or have not been diagnosed, adhere to the RICE philosophy within the first 48 - 72 hours. Gentle massage around the quadricep area or small flexing or extending movements will also help increase blood flow, oxygen, nutrients, and will prevent scar tissue development.