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Quadriceps Strain

Quadriceps strain typically affects the rectus femoris muscle. The rectus femoris is the only two joint muscle in the quadriceps, however all the four muscles receive innervation from the femoral nerve.

The indirect head of the rectus femoris gives rise to a central tendon in the proximal thigh leading to strains proximal to the musculotendinous junction. These strains can occur proximally or distally.


The quadriceps are commonly affected for because of these reasons

It crosses two joints, has a high percentage of type II fibers, and has a complex musculotendinous architecture.


The quadriceps strains are generally managed nonoperatively


  • In the acute phase, the treatment of quadriceps strains starts with the PRICE protocol to reduce the swelling and hematoma formation.
  • Severe strains may require a short period of crutch use.
  • Passive, pain-free stretching should also be initiated in the first 24 to 48 hours.
  • Isometric exercises and increasing movement within pain-free arc of motion are begun.
  • Eccentric contraction of the quadriceps are to be avoided.
  • Anti-inflammatory modalities are also instituted by the trainer or physiotherapist, along with ultrasound and electrical stimulation for moderate to severe strains.

Sudden forceful eccentric muscle contraction of the quadriceps is required during hip extension and knee flexion and can lead to increased forces across the muscle-tendon interface leading to strains.


Treatment Protocol for a Quadriceps Strain

PhaseActivity
 1RICE, NSAIDs
 2Isometric exercises
 3Isotonic exercises
 4Isokinetic exercises
 5Running, plyometrics, jumping exercises
 6Sport-specific training