Quadriceps Thigh Strain: Chiropractic

The quadriceps muscle consists of four muscles in front of the thigh that connects to the knee right below the knee cap. These muscles straighten the knee for walking, running, and jumping. They also help bend the knee for squatting. They move the leg forward when running and fire/transmit electrical impulses when the foot hits the ground to absorb shock. When jumping, the muscles provide stability coming down as well as when standing on one leg.

Quadriceps Strain

Thigh strains are common in sports. Most players are sidelined because of this injury when compared to strains in the hamstrings or groin. Factors that can increase the risk of injury include:

• Exhaustion
• Muscle weakness
• The strength of the quadriceps to the hamstrings is uneven, causing one set to get overused.
• Consistent sprinting and/or kicking
• Previous strain and/or injury

The quadriceps is made up of four muscles.  One is the rectus femoris, which gets injured the most. It’s the only muscle that crosses two joints – the hip joint and the knee joint.

Symptoms and Injury Grades

Individuals commonly report a pulling/stretching sensation in the front of the thigh. Common symptoms include:

• Pain
• Swelling
• Bruising
• Muscle tenderness
• For minor quadriceps strains or tears, moderate to dull pain presents along with stiff movement.

Grades categorize the severity of the strain:

• Grade 1 presents with mild discomfort in the thigh with no loss of strength.
• Grade 2 presents with moderate pain, swelling, and some loss of strength.
• Grade 3 is a complete rupture of the fibers. Individuals are in severe pain and unable to walk.
• Grade 3 is where surgery is required.

Symptoms can vary depending on the type of injury that has been sustained and the severity. There is pain and localized swelling for both strains and contusions. If a muscle rupture has happened, there could be a bump/lump within the muscle or a gap in the muscle. If rupture of the Quadriceps Tendon has occurred, individuals often report hearing a pop when the injury happens. The swelling often makes straightening the leg difficult or impossible.

Injury causes

Thigh strains usually happen when slowing down/decelerating after a sprint. This can be because the individual takes too small or too large steps causing the muscles to overstretch, much like a rubber band that, if overstretched, tears, and if under stretched, it bunches up, which can cause spasms and tears.

Treatment

In the initial stages after a quadriceps strain, it is recommended to follow the RICE Procedure for 24 hours: This includes:

• Rest
• Ice
• Compression
• Elevate
• The leg needs to be rested every 2-3 hours in 20-minute sessions.
• A bandage can provide added support.
• For slight tears and strains, it is recommended to stretch the quadriceps gently.
• This helps prevent the muscles from experiencing shortening. This happens by the formation of scar tissue that pulls the muscle/s, making them shorter.
• Gentle stretches allow the muscles to heal with minimal shortening. This helps prevent further and/or re-injury.

Chiropractic Physical Therapy Rehabilitation

After the acute stage of the injury, receiving regular chiropractic sports adjustments, physical therapy massage, coupled with strength training exercises will speed up recovery.

• Physical therapy massage will remove scar tissue and keep the muscle/s loose and flexible.
• Exercises for strengthening the muscles after injury will be recommended according to the individual’s condition/case.
• Following correct post-injury-care, exercises, and physical therapy.
• Healing time can be 4- 6 weeks.

Body Composition

Strength Training: The Inverted Row

This workout targets the back muscles, spine and scapular stabilizers, deep abdominals, and arms. Everyday activities that require various types of pulling motion, lifting, etc., become easier. To perform:

• Lie flat on your back.
• Grab a stable barbell or set of straps that are above you.
• Pull your upper body up as high as possible while keeping the back straight.
• Squeeze the shoulder blades together at the top.
• Complete as many reps as possible.
• Once enough strength and endurance have been built, try a pullup.

References

Kary, Joel M. “Diagnosis and management of quadriceps strains and contusions.” Current reviews in musculoskeletal medicine vol. 3,1-4 26-31. 30 Jul. 2010, doi:10.1007/s12178-010-9064-5

Hillermann, Bernd, et al. “A pilot study comparing the effects of spinal manipulative therapy with those of extra-spinal manipulative therapy on quadriceps muscle strength.” Journal of manipulative and physiological therapeutics vol. 29,2 (2006): 145-9. doi:10.1016/j.jmpt.2005.12.003

Wenban, Adrian B. “Influence of active release technique on quadriceps inhibition and strength: a pilot study.” Journal of manipulative and physiological therapeutics vol. 28,1 (2005): 73. doi:10.1016/j.jmpt.2004.12.015