Quadriceps A Runner’s Ultimate Strength: Stretches, Exercises and Injury Prevention

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Running is an exercise that engages the entire body. It is a powerful compound movement that takes advantage of the balance and lower body strength of humans in order to cover long distances in short periods of time. Our bodies have evolved in order to run more effectively; it has enabled our ancestors to hunt game and avoid predators, making superior running ability a requirement in order to survive. Each part of the body needs to work in tandem in order to accomplish this mechanical movement efficiently and effectively. That means if even one part of the body isn’t working properly, running ability will become severely limited.

Out of all the bones, joints, and muscles that make up our legs, one of the largest and most important groups of muscles located on the lower half of our body is the quadriceps. Called ‘quads’ for short, these are very powerful leg muscles that are important for bearing weight and generating the kinetic energy that enables us to run. If your quadriceps become injured, you will find running to be significantly more difficult: maybe even impossible. The information in this article will help you understand the quadriceps and what role they play in your body, identify any potential injuries in this area, treat these injuries effectively, and practice safe habits to avoid injury in the future.

What Are Quadriceps?

The quadriceps are a group of muscles that are located in your upper legs. They are four muscles found on the front of your thighs. The quadriceps are the muscles responsible for extending the knees and straightening the legs. Quads are muscles that allow for a person to walk and are why humans have the ability to jump, run, and perform other leg-based movements.

When these muscles are damaged or injured severely, it can cause a serious problem for a runner. In the end, severe enough injuries can even interfere with a runner’s everyday life, not just when on the track. For many people who sustain a quadricep injury, the cause is usually sports, with an accident sustained during a sporting event being the primary source of injury. The most common sports that individuals sustain a quadricep injury during are rugby, judo, karate, football, soccer, and track running. This isn’t to say that these are the only pastimes where an individual can injure their quads; quad injury can occur in much less intense activities, such as jogging or performing basic tasks around the home.

In general, women are much more prone to developing quads injury than men. For women who engage in track and undergo intensive workouts for track and field events, there have been numerous incidents where women have sustained serious injuries to the quadricep.

Parts of the Quadriceps

In order to understand what a quadricep injury is, it is important to understand what the quadricep is made up of. The quad muscles are responsible for the hip flexor and knee extender. As mentioned in the former section, the quadricep aids in the ability for individuals to walk and jump. They are very important muscles for getting around and as a result of an injury, improperly functioning quadriceps can greatly impact an individual’s life in a negative way.

Another important thing to understand in regards to quadricep injury is the different types of muscles it is comprised of. Quadriceps are made up of four different muscles:

  • Vastus medialis:  Located on the inner thighs, these muscles are responsible for knee extension.
  • Vastus intermedium:  These muscles are located in the middle part of the quadricep, near the femur. In addition to facilitating knee extension, they also allow for maximum knee flexion.
  • Vastus lateralis: Located on the outer thigh, these muscles are the largest and strongest among the quadriceps. It is also responsible for knee extension.
  • Rectus femoris: These muscles are located in the middle of the upper leg, on top of the vastus intermedium. It comprises part of the body’s hip flexors.

These four muscles make up the quadricep. What may come as a surprise to some individuals, and what can cause issues when diagnosing an injury, is that there are different kinds of quadricep pains associated with the different muscles in the quadricep. Depending on where the pain is located, it is possible that an injury has been sustained in one specific muscle. The pains that each of the muscles experience can all lead to different types of injuries in the quadricep, listed below:

IT-Band-Syndrome-featured

Contusions

These are bruises that are located in the quadriceps region and can cause great damage to the muscles. It is also referred to as dead leg or a Charley Horse and is caused by sudden impact to the thigh muscles. The trauma that this impact causes leads the contusion to either rupture or tear the muscle; in extreme cases, severe bruising can be observed on the skin level. As a result of extreme contusions, the emergence of a hematoma is possible.

Compartment Syndrome

This is a syndrome that increases the pressure in a region of the muscles. This pressure can come from excessive swelling or bleeding, and will often require surgical treatment to fix. Compartment syndrome often develops as a result of a contusion, fracture or crushing injury, such as a powerful impact. The drastic increase in pressure that develops in the affected limb can impede blood flow and cause tissue damage or even death in extreme cases.

Strained Quadriceps

This is one of the most common forms of quadricep injury. The quadricep can experience great deals of pain as a result of becoming strained. A muscle strain injury can lead to a loss of performance and strength in some cases, with more severe forms of strain developing worse injuries. The majority of muscle strain cases can be treated with the RICE protocol, but more severe cases may need surgical treatment to fix. Strain injuries come in three grades. These grades include:

  • Grade 1: These are strains that are caused because the muscle has been overstretched but not torn.
  • Grade 2: These strains are where the muscle is partially torn, causing significant damage to the muscles.
  • Grade 3: These strains occur when the muscle is completely torn.

Tendinopathy

Tendinopathy is commonly observed in the foot, but quadricep tendinitis is actually quite common. This injury emerges as a result of degeneration of the tendons or after the scarring of a tendon because of repetitive injury. It is especially common for individuals who engage in full contact sports, although runners are also at risk of potentially developing this injury. This particular form of tendinitis is located in the lower thigh, right above the knee. It is commonly treated with the RICE protocol and the administration of anti-inflammatory medication.

Osgood-Schlatter Disease

This disease, also called apophysitis of the tibial tubercle, happens when there is inflammation located in the bone. This is among the most painful injuries a person can experience in their quadriceps. One of the common symptoms of this disease is a bump on one or both of the individual’s knees. Resting is the most effective way to treat this injury, although it has been known to reappear after treatment. Effective treatment methods include physical therapy and surgery in older sufferers.

Symptoms of Quadriceps Injury

With the knowledge of different injuries that can be sustained to the quadriceps, it becomes easier to notice signs of a quadriceps injury and differentiate more serious problems from a minor stinging sensation. Often times the pain a person may feel can sometimes be overlooked; because so many of us work hard and strenuous jobs, it is not uncommon to dismiss aches and pains in the body as simple soreness and nothing more. A body being sore and tired is not unheard of and it is because of this that a person may misdiagnose their situation. However, there are certain symptoms that a person should be aware of in order to help them determine if they have sustained a quadricep injury. These symptoms are not relevant for all potential injuries sustained to the quadriceps, but they are common enough that they should be investigated as potentially indicative of an injury.

Hamstring tendinopathy

  • Swelling
  • Stiffness
  • Soreness
  • Decreased range of motion
  • Difficulty straightening the leg
  • Difficult standing or walking
  • Development of bumps around the knee

If an individual has experienced any of these symptoms, it is highly recommended that they visit a doctor or a physical therapist. A medical professional will be able to help identify an injury and can apply proper treatment in order to prevent it from getting worse over time.

Causes of Quadriceps Injury

There are numerous causes for a person to develop quadricep injury. The quadricep is a muscle that is easily harmed because of how exposed the muscle is, especially for those who engage in contact sports. Some of the major causes for specific injuries include:

Contusion causes

This is perhaps one of the most common ways in which a person can sustain a quadricep injury. It is particularly common among individuals who participate in full contact sports such as football and rugby, or full-contact combative sports such as Tae Kwon Do and kickboxing. A contusion causes significant amounts of damage to the muscle fibers and is thus one of the reasons the muscles start to swell. If there have been significant amounts of impact to the quadriceps, there is the possibility that the femur can be fractured or completely broken.  This cause of injury is not uncommon, especially among young males.

Compartment syndrome causes

Compartment syndrome is a much more severe type of quadriceps injury, as this syndrome requires the person to undergo a surgical operation for treatment. The primary cause of this injury is a previous injury, such as a broken bone. In cases where too much compression has been applied to the wound, the pressure in the leg becomes so high it prevents adequate blood flow to the muscle itself. As a result, the muscle cells start to die because they are not receiving enough oxygen supply.

Muscle strain causes

Strain in the quadriceps is another very common cause of injury. Repetitive improper use of the muscles, or overuse without adequate periods of rest, can cause the muscle to tear and the muscle fibers to become inflamed.  Most individuals strain their muscle from lifting weights, which causes the muscle to fatigue and leads to muscle tears. In fact, this is part of the hypertrophy process, which is necessary for muscle growth in bodybuilding. Individuals who experience quadricep strain are usually those who participate in athletic games. Females are also much more prone to developing this kind of injury. In fact, the majority of research has shown that women are far more likely than men to develop a strain in the quadriceps muscles. This is especially true if these women engage in track and running exercises.

Partial tear causes

Partial tears can be caused by engaging in a competitive combative sport, such as kickboxing or Tae Kwon Do. Receiving an impactful kick to the quadriceps can cause significant tearing to the muscle. In some cases, a severe impact can even cause a complete rupture in the muscle. Other common causes for partial tearing in the quadriceps include falling awkwardly or the presence of degenerative autoimmune diseases, such as gout and rheumatoid arthritis.

Tendinopathy causes

Tendinitis is an inflammation of the tendon, also known as tendinopathy. This is significant because these tendons attach the quadricep muscles to the tibial tubercle, allowing for leg and knee movement. A person may develop this kind of injury because of a powerful impact force, either due to contact sport or from accidental trauma such as falling.

False Positives of Quadriceps Injury

If you or someone you know suspect that they are suffering from an injury to their quadriceps, it is important to obtain a proper diagnosis and receive immediate treatment. The risk that you take on in putting off obtaining a proper diagnosis is the potential of improperly treating your injury because you are unaware of what specific ailment you are suffering from. As mentioned above, there are many potential injuries that can afflict the upper leg that will require different treatment methods. In addition to the specific injuries that affect the quadriceps, here are some similar injuries that affect the same general area but have different causes and methods of treatment.

Stress Fracture

In some situations where excessive trauma is sustained to the upper leg, it is possible that the damage is more severe to the bone than the muscle. This is especially common in individuals without as much mass or muscle definition. Stress fractures range in severity, but they all involve structural damage to the bone. Similar symptoms can be observed to a quadriceps injury, but some cases will have abnormal bulging in the affected area. Another way to tell the difference between these two conditions is to observe when pain is experienced; bone damage will cause pain when bearing weight, and muscle damage will cause pain when performing basic leg movement. Treatment methods for stress fractures are similar to quad strain, but may also involve installing bone grafts and plates through surgery in extreme cases.

Bone Avulsion

This is a more severe form of a stress fracture. What makes this injury different from an ordinary bone fracture is it involves a piece of bone detaching completely, which can become lodged in another part of the leg and cause severe discomfort. They are commonly caused by car accidents, but any trauma severe enough to cause bone injury carries the risk of bone avulsion. Determining which bone is injured and where the fractured bone particles have become lodged will help doctors to differentiate this injury from regular stress fractures or muscle strain, as it can occur in the knee or shin. If symptoms of quad injury such as soreness, stiffness, and reduced mobility are observed in other parts of the leg, it is possible that a bone avulsion is a culprit.

Deep-Vein Thrombosis

Sometimes a clot can form in the veins of an individual’s leg. This can be due to many potential factors, with the most common being age, diet and lifestyle. Deep vein thrombosis is the name for this condition, and it can be confused with less serious injuries sustained to the quadriceps, as they affect the same area of the body. This is because it can exhibit the common symptoms of swelling, redness, and bruising. Treatment for this injury involves taking blood-thinning medication as well as making changes to the sufferer’s diet and lifestyle. It is extremely important to determine if this is the cause of injury, as it is possible for cases of DVT to develop into a potentially life-threatening pulmonary embolism.

Arthritis

For individuals who are older or suffer from some variety of auto-immune disease, arthritis can be a potential cause of leg pain. In some cases, arthritis can be distinguished from quadriceps-related injuries by figuring out if the pain and inflammation are located higher up the leg, near the muscle, or lower, near the joints. Arthritis can also be identified if a similar pain is felt in other areas of the body, especially if this pain is localized near the joints. Treatment for arthritis is very different from treating injuries to the leg muscles and varies even more based on the particular kind of arthritis the individual is suffering from.

Complications of Quadriceps Injury

In addition to an understanding some potential causes of quadricep injury and some false positives, it is important to know how these injuries can worsen. Failing to take the necessary steps in order to treat these injuries can lead to much more painful conditions. If these injuries aren’t treated as soon as possible then they can become much worse over time. Some potential complications include:

Myositis Ossificans

In some cases of extreme or repetitive muscle strain, this condition can occur. It involves the development of bone tissue instead of muscle tissue in the injured area, causing the formation of a hard lump. Myositis ossificans can cause severe pain and decrease the range of motion in the affected area: in this case, the quadriceps. This is a condition that will interfere with the daily activities of an individual’s life, but treatment is possible. Mild cases can usually be treated with a combination of physical therapy and anti-inflammatory medicine (NSAIDs), while more severe cases may require the use of ultrasound therapy or surgery.

Hematoma

Often as a result of severe impact or bruising, a hematoma can occur in the quadriceps after injury. If a contusion is improperly treated in time, capillaries can tear and cause red blood cells to pool in other parts of the body, such as the surrounding tissue. This will often cause irritation in the affected tissue, signified by swelling and redness as well as pain. There are different types of hematomas that can afflict different parts of the body, but quadricep-related cases fall under the subcategory of intramuscular hematomas. Treatment commonly involves the RICE protocol, but it is also important to avoid taking blood thinning medication while recovering as it can exacerbate the internal bleeding.

Rupture

The complete rupturing of any muscle is very serious and debilitating. This is why many experts and coaches will inform anyone engaging in an intensive workout to seek immediate help if they have sustained an injury in the quadriceps, so as to avoid a rupture. As stated earlier, a torn muscle can later develop into a rupture and, as a result, whatever sport or physically demanding activity a person engages in will have to be put on hold for the time it takes to heal their muscles.  Quadriceps ruptures are more common amongst individuals over 40 than those who are younger. However, younger individuals may still suffer from a quadriceps rupture, especially if they have sustained extreme trauma such as a car crash or fall from a great height.  It is crucial that as soon as you have developed this injury, you do your best to try and manage the injury through RICE protocol and protective gear such as splints and braces. If not, the injury can develop into a far more serious condition that will affect the overall quality of your life.

Diagnosing Quadriceps Injury

For those individuals who have sustained a quadricep injury, there are many ways for a doctor or similar medical professional to diagnose the injury. This is an extremely important step regarding treatment for your injury; failing to ascertain with complete certainty what injury you are suffering from can result in improper and ineffective treatment. Failing to properly treat your injury can waste your time and money in the best case scenario, and cause more severe and potentially permanent bodily damage in the worst cases. Because of this, you should always consult a medical professional and obtain a proper diagnosis before attempting treatment. These are some methods a doctor may use to determine what is the cause of your symptoms. From there, both you and your doctor can work towards treating it.

Physical Examination

The doctor may give you a physical examination to determine the severity of the injury. This is very helpful as the physical examination will be able to determine what type of treatment will be best for the injury depending on the severity. At first, your doctor may ask you a few questions about your levels of activity and medical history, but they will then engage in a hands-on examination. This may involve poking and prodding areas of your body in order to determine how much pain you feel, as well as testing your flexibility and reflexes. From here, it is possible to be diagnosed with an exact injury relating to your symptoms, but what is more likely is that your doctor will want to try some other diagnostic methods as well.

One particular physical examination is very effective at diagnosing and evaluating the severity of compartment syndrome. By inserting a probe in and around the muscle compartment, pressure can be measured as well as pain experienced by the patient. If excesses of either pain or pressure are observed, the most likely culprit is compartment syndrome; however, more thorough diagnostics may still be performed through the use of imaging scans.

X-Ray

The doctors will most likely perform an X-ray to determine if the pain that an individual feels in the quadricep is not because of a broken femur or a fractured femur. Often times, fractured or broken bones can cut many of the muscles in the legs because of their sharpness. To determine if this is the cause of your symptoms, a doctor can take radiographs, a term for radioactive pictures, of your affected leg. These pictures will capture the detail of what is under your skin and tissue, allowing your doctor to observe what condition your bones are in. This can rule out stress fractures and bony avulsions as false positives.

CT Scan 

Unlike an x-ray, a CT Scan has the ability to determine if the pain that a person is feeling is caused by a broken femur or a torn muscle. CT Scans are much more informative than standard radiographs when diagnosing the cause and condition of an injury. This is because the computerized topography scans taken by a CT scan machine can capture multiple angles, and can be used to observe the state of tissue as well as bone. CT scans may be performed after an x-ray scan or in lieu of an x-ray scan, as they can rule out even more false positives such as arthritis.

MRI Scan

MRI’s are the most sophisticated of the three scans mentioned. As opposed to the former two methods, which use radiation to capture images of the body, The Magnetic Resonance Imaging scanner uses magnets to capture a significant amount of detail from the targeted limb. A much more precise diagnosis of the cause of injury can be determined in this way since the full 360-degree scan of the targeted body part can analyze muscle, tissue, and bone discrepancies. MRI scanning can help your doctor discover if the pain you are experiencing is because of a broken or fractured bone, or if the pain you feel is from a pulled muscle.

Ultrasound Scan

Ultrasound technology may be used to determine if the pain the individual is feeling is caused by a rupture. This type of scan is commonly used on pregnant women in order to monitor their babies because it doesn’t involve exposing the body to dangerous radioactive elements like with X-rays. Instead, this type of scan involves using sound waves to take similar images of the body, which can be used in cases where patients would not be able to have an X-ray or MRI scan. Although ultrasound therapy is a common and effective treatment method for some forms of quadricep injury, the type of ultrasound used in performing diagnostic scans is different from the therapeutic kind used for treatment.

A very effective diagnosis can be made by the bedside in the majority of cases. However, sometimes a doctor will recommend using X-ray, CT or MRI scans in order to have a clearer understanding of what is broken or torn. For cases where you are unable to have these scans performed, an ultrasound scan may be used instead.

Prognosis

After getting your diagnosis of the injury, the doctors will be able to tell you how you can begin recovery and how long it is estimated to take. Certain forms of treatments will be recommended based on what specific injury you have sustained to your leg muscles, and whether or not surgery will be necessary. These treatments will either alleviate some of the pain or will help to completely heal the injury. Because this injury is curable, there are many cases where the individual goes back to full functionality in a short amount of time. The following section will cover all the treatments that are available to heal or treat injuries sustained to the quadriceps.

Treatment

Since this is a very common injury among many people, there have been many treatments developed that can both treat the condition and relieve pain. Many of these treatments can completely cure the person of the injury they have sustained. Alternatively, some of the treatments listed below only help to alleviate pain for a short period of time, which may then be done in conjunction with surgery. Some of these treatments include:

R.I.C.E 

This is perhaps the most common treatment that a person who has sustained some kind of quadricep injury will be treated with. In fact, RICE treatment is one of the most common forms of immediate first aid used for any muscle injury, not just the quadriceps. This treatment is very popular amongst the athletic community in particular, as it has a very high success rate of treating the pain a person may be experiencing and preventing the injury from becoming more severe. RICE is an acronym that describes the methods used and in what order. They are:

  • Rest: The benefits of resting is crucial for the healing process to begin. Allowing the muscles to rest help to start the healing process by taking less strain on the muscle and allowing it to relax. Immediately stop all activity and take a break from any activity that can put stress on your quadriceps.
  • Ice: Icing is an extremely productive treatment that helps to speed up recovery time and relieve pain. The extreme cold works to prevent swelling and numbs the area, which takes care of two common symptoms. A standard ice pack works best, but if you don’t have access to one you can use a bag of frozen vegetables or a sandwich bag full of ice cubes as alternatives. Apply the ice for no more than twenty minutes every hour, and consider wrapping your ice pack in some cloth if your skin is sensitive to cold.
  • Compression: Compressing the region where there is significant pain will help speed the recovery process as well. This is because applying compression to your injured leg will prevent further swelling and make sure your leg doesn’t heal awkwardly. There are compression sleeves designed for your upper legs, but you can also apply a few layers of medical tape to achieve the same effect.
  • Elevation: Raising the leg will allow for easier blood flow throughout the leg, preventing excessive blood from pooling, and allow for the muscle to relax. This can be achieved by using a footrest or ottoman while sitting, and you can rest your foot on a few pillows while lying in bed. In order to achieve the best results, make sure that your leg is elevated above your heart.

For minor injuries such as strains or compartment syndrome, RICE treatment should be sufficient in facilitating a full recovery. However, some cases may require additional assistance in the form of medication.

Medication

Medication is highly effective in treating injuries to the quadriceps in all forms, with different types of medicine being effective at treating different forms of injury. The medication that is usually prescribed is over the counter drugs that an individual can purchase at a pharmacy or supermarket without a prescription. These mild drugs will most likely be pain-relieving anti-inflammatory pills that will be able to alleviate the pain for a while. However, more severe cases of leg muscle injury will require more potent medicine, which may need to be prescribed to you by a physician. These more advanced medications include steroids for muscle recovery, and powerful pain relievers such as opioids to assist in recovering from surgery.

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NSAIDs

These are over the counter painkillers used for a variety of painful conditions, such as headaches and menstrual cramps. NSAID is an acronym for Non-Steroidal Anti-Inflammatory medicine, and they work by reducing any swelling in the body while temporarily dulling pain receptors. Despite these medicines being mild and available without a prescription, be careful when taking them. Developing high blood pressure is one potential side effect, and some individuals will have an adverse reaction to it if they are allergic. Popular NSAIDs include:

  • Ibuprofen, found commonly in Motrin and Advil
  • Aspirin, commonly found in Exedrin
  • Acetaminophen, found commonly in Tylenol
  • Naproxen, commonly found in Aleve

Antibiotics

In some cases, it may be an infection that is causing leg muscle injury. For these situations, a doctor may prescribe antibiotics in order to treat your condition. These work to prevent the creation of harmful bacteria in the body which can begin developing an infection. Often, these medications will require a prescription, so be sure to consult with a medical professional if you believe this is the best course of action. If you do decide to take antibiotics, be sure to take your full prescription for the entire length of time you are instructed to, even if you feel better before you are finished. Failing to complete your medication cycle with antibiotics can cause bacteria to come back; in fact, it is possible that the bacteria that reinfects your body is resistant to antibiotics, making treatment much more difficult the second time around. Some common antibiotics that may be prescribed are:

  • Fluoroquinolone
  • Ciprofloxacin (Cipro)
  • Cetraxal
  • ProQuin
  • Levofloxacin
  • Levaquin
  • Quixin
  • Iquix

Corticosteroids

For individuals who suffer from more severe muscle injuries such as bone avulsion or muscle tearing, they may have to be injected with a corticosteroid in order to stop the inflammation. In addition to providing pain relief, steroids greatly increase the ability for the body to recover muscle tissue. It does this by stimulating the production of growth hormone in the body, as well as providing artificial versions of this growth hormone. Although corticosteroids can be extremely beneficial in some situations, there are some flaws with this form of treatment. Side effects can be severe with excessive injections, including mood swings and hormone imbalances. Another downside is the fact that this treatment only helps for a short period of time as a recovery accelerant, and will not completely cure the underlying cause of injury. Still, these controlled substances may be prescribed and administered to you by a medical professional if they have determined that it is appropriate for your situation. Some common corticosteroids include:

  • Cortisone
  • Cotolone
  • Celestone
  • Medrol
  • Methylprednisone
  • Prednicot
  • Pulmicort

Opioids

These are some of the most powerful medications prescribed when treating injuries to the quadriceps. They are usually reserved for use after a surgical procedure but may be prescribed in cases of extreme pain. Opioids are powerful painkillers that can numb the body of pain for long periods of time. They can be thought of as much more powerful NSAIDs, only without the anti-inflammatory effects. Be very careful if you are prescribed opioids, as the danger of developing an addiction to these controlled narcotic substances is incredibly high. Some common opioids are:

  • Morphine
  • Codeine
  • Oxycodone
  • Hydrocodone
  • Methadone
  • Fentanyl
  • Tramadol

Orthotics

Assisted walking devices can help to alleviate a number of symptoms, and can be useful in treatment when used in conjunction with other methods. For example, crutches are highly effective at relieving pressure on individual places of the leg that may cause pain. Braces are another highly effective tool for use in recovery; they come in a variety of styles in order to accommodate different forms of leg muscle injury as well as different degrees of severity. Some braces work to limit the leg’s range of motion, while others assist in bearing weight so that light activity such as walking is possible. Some braces will also immobilize the affected leg completely, which is terrific for use in conjunction with RICE therapy. These orthotic tools will not completely heal any injury on their own, but it will help to alleviate the pain and reduce stress on the muscles.

Surgery

There are some incidents of leg muscle injury where a surgical operation is necessary. This is the most serious and invasive method of treatment used only as a last resort. However, after a successful surgery, any issues should be completely fixed, with the only immediate concern for the patient being their recovery from the operation. In some rare cases it is necessary to have a follow-up surgery a few years down the line, but for the most part, this very expensive and invasive method of treatment is the final word on curing injuries sustained to the quadriceps.

Tendon Repair

The most common situations in which surgery is needed for quadriceps injuries involve severe muscle tearing. In cases where the lower portion of the middle thigh tendon, or vastus intermedium, is torn completely from the kneecap, a surgical procedure is conducted with the aim of reattaching this tendon. This usually requires drilling holes in the kneecap in order to sew the tendon back to it with the use of sutures. In recent years, technology has advanced to the point where surgeons no longer need to drill these holes, using specialized anchors for the sutures instead. However, the majority of procedures will still involve drilling holes, as this emergent technology has yet to become commonplace.

Quadricepsplasty

Another surgical procedure that can be performed in order to treat injuries in this area of the body is a quadricepsplasty. This is an invasive procedure that can increase the patient’s range of motion in their leg. This is ideal for sufferers of severe muscle strain who lose some mobility as a consequence. After an incision is made, the vastus lateralis is lengthened in small increments until the desired range of motion is achieved, at which point the leg is then sewn back up.

With an understanding of the different types of treatments that are available for those who have sustained this injury, the next most pertinent information you should know is how to prevent these injuries from occurring. Prevention is always better than the treatment, and exercising the methods listed below will help to prevent injury for those who are uninjured, and to prevent re-injury for those who are recently recovered. Effective practice of the exercises and dietary choices below should save you a great deal of time and money, allowing you to focus on running and any other passions that move you.

Preventing Quadriceps Injury

Depending on the initial cause, methods of preventing a quadricep injury can vary. However, one thing that all of these techniques have in common is that they are simple and will not take a great deal of time or energy out of your daily routine. In addition to preventing quadriceps injuries, these methods will help prevent a plethora of potential running injuries and can improve your overall quality of life. There are some causes of quadricep injury that you may not be able to prevent, such as trauma from a car accident, but the ones that can be prevented will be prevented by following these tips:

Stretching

Whether you engage in high-impact sports or simply practice casual running, it is recommended by many athletic experts and coaches that you stretch before engaging in your activity of choice. Stretching serves a few purposes: it encourages blood flow throughout the muscles, it activates certain muscle groups so they are engaged in the physical activity, and it works to prevent tearing, swelling, or strain. Certain types of stretches and stretching techniques are so popular that many individuals practice them as regular exercise, not just as a preparation for other physical activities. In particular, yoga is a very popular stretching related martial art, with many practitioners reaping the benefits it has on their mood as well as on their body flexibility.

The following stretches and yoga poses will target the quadriceps and related muscle groups, helping to prevent these muscles from becoming injured during regular exercise. Some of the stretches listed may require additional equipment to perform properly, such as a mat or rug. You should expect to feel some mild soreness when performing these movements, but stop immediately and seek medical attention if you experience sharp pain.

  • Standing Quad Stretch: Begin by standing up straight with your hands at your sides. While supporting your weight on one leg, bend your other leg backward at the knee. Grab the foot of your bent leg with your respective hand and pull it toward your buttocks until you feel a tension in your thigh. Hold this position for ten to twenty seconds, then release. Repeat this stretch with the other leg and hand. Perform this stretch up to three times for each leg.
  • Lunges: Begin by standing up straight with your feet spaced slightly apart. Take a large step forward with one leg while bending both, lowering your torso closer to the ground while keeping it upright. Your front leg should be bent at the knee at a 90-degree angle, with the knee of your other leg inches from the ground. If done correctly, you should feel some tension in your hip and back thigh. Hold this position for twenty to thirty seconds, then return to the starting position. Repeat this movement with your other leg in front, holding for another twenty to thirty seconds. Perform this stretch up to three times with each leg.
  • Crescent Lunges: This yoga stretch is a variation of the standard lunge, and is also referred to as Anjaneyasana. The difference between this move and a standard lunge is the depth at which your knee is bent. Your front knee should be bent at a much more acute angle, around 45 degrees, and your back leg should curve backward with your knee and lower leg resting on the ground. Lift both of your arms up in the air while forming this pose to assist with balance and breathing. Hold this pose for up to thirty seconds, then relax and repeat with the other leg in front for another thirty seconds.
  • Dancer Pose: This is an advanced yoga pose, also known as Natarajasana or King Dancer. Begin by standing upright. Distribute your weight to one leg, and lift your other leg behind you without bending it. Bring your upper body forward and stick your opposite arm out in front of you as a counterbalance. Grab the foot of your back leg with your other arm and pull it up until your foot is at the same height level as your head. Hold this position for twenty to thirty seconds, return to the starting position, and repeat with the opposite leg and arm for another twenty to thirty seconds.

Relaxation Therapy

Relaxation has the benefit of allowing an individual to be more receptive to impact, thus reducing the damage and pain associated with injury. There are many active and passive health benefits to reducing one’s stress and anxiety as well. In addition to lowering blood pressure and resting heart rate, reducing stress will limit the body’s production of cortisol, a serum the body produces that can cause excessive fat buildup. This means that practicing techniques to lower the amount of stress in your life can lead to weight loss and improved cardiovascular functionality, with will have a positive impact on your running ability.

Relaxation therapy is a catch-all term for many different techniques and methods you can use to promote relaxation in the body. Meditation is a common method used in this form of therapy, as are low-impact martial arts such as Tai Chi and Chi Gong. This form of therapy is highly recommended by many coaches and physical therapists for both recovery and prevention. It is most important for females to consider relaxation therapy since they are much more prone to developing quadriceps injuries, but men should also consider adopting some of the following methods of relaxation:

  • Meditation
  • Sensory Deprivation
  • Tai Chi
  • Chi Gong
  • Yoga
  • Aromatherapy
  • Herbal Baths

Diet

One of the best and most effective ways to ensure your body is healthy and ready for physical activity is to maintain a good diet. Exercise and sleep are important for bodily function, but your diet is the biggest determinant when it comes to your overall health. In order to prevent injuries to your quadriceps and to recover from any other injuries faster, you should try and keep a diet high in necessary vitamins and minerals and low in foods that can contribute to negative health effects. Here are some substances you should avoid eating too much of:

  • Cholesterol: Eating a diet that is too high in cholesterol can lead to inflammation, which will cause chronic pain and can increase your likelihood of muscle strain and cardiovascular problems. This happens because of an excessive buildup of low-density lipoprotein, or LDL. Certain types of cholesterol cause this protein to be synthesized in the body and too much cholesterol will cause LDL production to increase to the point where it begins to enter the arteries. It is recommended by nutritionists that you avoid eating too many dairy products, such as cheese and eggs.
  • Saturated Fat: A diet with an excess of saturated fats can cause inflammation due to the effect it has on adipose tissue. As opposed to brown fats which are responsible for expending energy, saturated fats build up in the body so they can store energy. This has the effect of releasing inflammatory chemicals in the body, which can exacerbate otherwise harmless injuries into more severe calamities that require more time and effort to fully recover from. Foods that are high in saturated fats you should limit in your diet include burgers, pizza, and potato chips.
  • Alcohol: It is true that some forms of alcohol, when drank in moderation, can contribute positive effects on the body in regards to antioxidants and probiotics. However, drinking to excess can cause serious damage to your liver, which will affect a variety of normal bodily functions. A faulty liver will increase stress levels, introduce toxins to your gut bacteria, and weaken your immune system. This will again result in chronic pain and increase the duration and intensity of injuries. Some alcoholic drinks to avoid are beers (even light beers), and sugary mixed drinks such as margaritas and pina coladas.
  • Sugar: Sugar is important for providing the human body with energy through the production of glucose, but a diet with too much sugar can have serious adverse effects. If you eat sugar at a rate where your body is unable to process it, a buildup of cytokines will result. This has the effect of increased inflammation and weakening the immune system, which will lead to more problems down the line. The most deceptive and damaging sources of excess amounts of sugar come in liquid forms, such as soda or sweet coffee drinks.

In lieu of these harmful substances, you may wish to consider eating foods with these nutrients instead:

  • Fiber: Foods rich in fiber such as whole grains have an adverse effect on your gut flora and digestive system that alcohol does. What this means is that eating more fiber will help your digestive system, improving its ability to resist inflammation-causing substances such as cholesterol.
  • Omega-3: Considered an essential nutrient to normal body functionality, Omega-3 fatty acids are only accessible through food or supplements. This means that your body doesn’t produce this substance internally but needs to obtain it through external means. Numerous studies have been conducted proving how effective Omega-3s are in preventing inflammation and may even be linked to reducing the risk of cancer and heart disease. The best source of this nutrient is through fish, but supplements are a decent alternative.
  • Anthocyanins: There are certain fruits, vegetables, and grains that contain high amounts of anthocyanins. The effect this specific flavonoid has on the body is extremely beneficial; it can reduce inflammation, improve mental function, and will go a long way toward preventing obesity. Anthocyanins are found in foods with bright colors, such as berries and oranges, and certain types of legumes have high concentrations as well, such as kidney beans and black rice.
  • Vitamin K: The benefits that Vitamin K have on the body are mostly related to recovery, as it can be very helpful regulating blood clotting and preventing soft tissue from hardening. These effects are very helpful for treating and preventing muscle injury, but Vitamin K can also work to prevent bone injury with the effects it has on calcium production in the body. High amounts of Vitamin K can be found in leafy green vegetables, such as kale and spinach, and in green tea.

In addition to maintaining a healthy diet, you should also ensure that you are properly hydrated in order to prevent a variety of injuries. Water has numerous documented benefits that can all lead to a much healthier and stronger body. Because the body is mostly made of water, it needs adequate amounts of water to function correctly. The muscles themselves are mostly made of water and drinking an adequate amount of water will allow your body to function at its best. You could have a diet rich in the nutrients that keep you healthy, but without enough water, your body may fail to properly harness these nutrients. The common wisdom of eight glasses a day isn’t backed by any scientific evidence, but it’s still a good recommendation for the majority of individuals. Ultimately, you are the person who knows their body best: drink as much water as your body tells you it needs, and you should be okay.

 

Strengthening Exercises

For many athletes that have sustained an injury, the primary cause was weak muscles or overstrained muscles that were fatigued from long periods of activity. Regular exercise is important not just for the quadriceps, but for muscles in the entire body. This is why professional athletes engage in full-body resistance training to strengthen their muscles. Stronger muscles become more resistant, more efficient, and more powerful, which leads to increased athletic ability and a decreased rate of injury. There are many types of exercises a person can do to increase their leg muscle strength in particular. Some of these exercises will require additional material to perform, such as a resistance band, a mat, or weights. Remember to expect some soreness both when performing these exercises and after, but stop immediately and seek medical attention if you experience sharp pain.

Bodyweight Squats: This exercise is fairly simple but can provide numerous positive results. Squats target the quadriceps and strengthen the muscles which work to prevent injury, increase power when running, and improve posture.

Patellar-tendinitis-squats

  • Step 1: Begin by standing upright with your feet shoulder width apart and your arms in front of you for balance. For added difficulty, you can place your arms on top of your head instead.
  • Step 2: Slowly lower your upper body by bending your legs while keeping your torso straight and your butt sticking out. Lower your body until your butt is lower than your hips, using your arms as a counterbalance if needed.
  • Step 3: Slowly raise your upper body back to the starting position by pushing off the ground with your legs. You should feel resistance in your thighs.

Repeat this exercise ten to fifteen times for one set. Try to perform two to three sets a day. Once this has become easier, you may want to move on to weighted squats.

Weighted Squats: Although similar to the basic squat, the weighted squat is a bit more difficult as you now have weights on your shoulders that add to the strain placed on your quadriceps. This exercise can be performed with two dumbbells in your hand, or by placing a barbell on your back. Proper form is extremely important with this exercise, as it can cause strain and damage to your back if you aren’t careful.

  • Step 1: Pick a weight to hold that you can handle. It should be heavy enough to challenge your leg muscles, but not so heavy that you can’t perform a single rep. For dumbells, a good starting weight is around 30-40 pounds in each hand. For barbells, anywhere from 125-135 pounds is a good starting weight, provided you have a spotter or are exercising in a power rack.
  • Step 2: Your starting position will vary depending on what kind of weight you are using. For dumbells, hold the weights in your hand above your shoulders so they at your head level. For barbells, place the bar on your upper back or trapezius muscles. In either position, position yourself so your feet are shoulder width apart, your torso is upright, and your butt is sticking out.
  • Step 3: Slowly lower and then raise your body in the same way as the bodyweight squat, making sure to not stop lowering until your butt is below your knee level. If you are unable to reach this depth in your squat, use a lighter weight.

Repeat this exercise up to five times for one set, and try to perform up to five sets a day in order to maximize muscle engagement without causing fatigue or injury. Be sure not to lock your knees when returning to the starting psoition, as this can potentially lead to injury.

Weighted Lunges – Lunges are an excellent stretching exercise when performed with just your bodyweight, as outlined in the stretching section above. However, much like squats, they are much more difficult as you add more weight in the form of dumbbells held in either hand. Weighted lunges target the quadriceps of one leg at a time, which increased the difficulty of the exercise. Because of that, you may want to use a lower weight when performing these lunges than you use when performing squats.

  • Step 1: Begin by standing upright with your feet spaced slightly apart and one dumbbell in each hand.
  • Step 2: Take a large step forward with one leg and bend your knee, lowering your upper body while keeping it and your arms in the same position.
  • Step 3: Lower your body until your front leg is bent at a 90-degree angle and your back knee is inches from the ground. Hold this position for a few seconds.
  • Step 4: Slowly lift your upper body back up and return to the starting position. Repeat this movement with the opposite leg in front.

Leg Press – This exercise is very beneficial for individuals who desire to strengthen their quadricep muscle. It can only be performed with the use of a special machine, usually found at a gym or fitness center. You can perform this exercise with a machine that is either parallel to the ground, or a machine that is placed on an incline with the weights above you. The incline variation of this machine is more challenging, but the risk of injury is higher, so be extremely careful when using this machine and consider getting a spotter to help you.

  • Step 1: Sit down in the chair, adjusting the seat if necessary so that your back is against the back of the chair and your knees are bent with your feet touching the large foot plate. There should be a visual diagram on the side of the machine that can serve as a reference.
  • Step 2: Using the pin and peg system, adjust the weight to a level you are comfortable with. For incline machines, you may need to add weight manually with weighted plates. If you perform squats regularly, you should set it to a similar weight that you can squat or lighter.
  • Steps 3: Start the movement by pushing on the plate with your feet. Push it until your legs are straight, but do not lock your knees. Locking your knees can cause severe injury, especially on an incline machine.
  • Step 4: Release pressure on your feet, slowly lowering the foot plate back to the starting position.

Repeat this exercise ten to fifteen times for each set, and perform up to three sets every day.

Conclusion

Quadricep injury is surprisingly prevalent in the athletic community. As a result of how prevalent these injuries are, there have been many scientific studies and reseach cases that have determined the different sources and variety of these injuries, as well as the best ways to treat and prevent them.

Leg muscle injuries are extremely painful and damaging to the individual. Each injury to the quadriceps carries a strong chance that it will result in an extended period of inactivity furing the recovery process, resulting in a loss of progress for athletes. However, with proper warm up stretches, a proper diet, and mindful practices, this injury is extremely easy to prevent.

A note on the sources used for this article

The sources used for this articles are listed below. The sites listed below are professional publications and journals, with information coming from experts in the fields. The sites that were used as sources for this article have all been written by a medical or athletic professional. However, you should not take the information that has been written in this article as medical advice. Always go to a doctor if you believe you are experiencing a medical injury.

Co-written by Mike Valverde

Curated by Diana Rangaves, PharmD, RPh

 

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