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The quad is the muscle located at the front of the thigh and comprises of four separate muscles to make up the quadriceps unit. This includes vastus intermedius, vastus medialis, vastus lateralis and rectus femoris. The primary function of these muscles is to extend or straighten the knee. The quadriceps are at a higher risk of a strain as it is biarthrodial (crosses two joint), thus more vulnerable to injury. A muscular strain of the quadriceps can involve any of these muscles or several together.
Muscle injuries are the most common injuries in sport, therefore they are likely to occur. You can strain your quad muscle. A strain is over-stretching of the muscle tissue through overload, as a result muscle fibres tear. A muscle strain typically happens during an explosive movement such as jumping, turning, sprinting or a change of pace. Factors that can predispose an individual to injury include:
Depending on the severity, muscle strains are in different categories.
Grade 1: Mild damage to muscle fibres (less than 5% of fibres) causing minimal loss of movement and strength.
Grade 2: A larger tear resulting in partial rupture of muscle fibres. Less than 50% loss of function and considerable pain on contraction.
Grade 3: Complete muscle rupture. More than 50% loss of range of movement and severe pain on contraction.
Treatment for muscle strains is a well-known acronym P.R.I.C.E which aims to minimise the extent of the injury. This is a way to recover from a quad strain. This stands for Protect- off load the injured area and protect from further damage. Rest- stop activity and rest as advised by your physiotherapist. Ice- apply ice to the affected area for 10-15 minutes, this can be done on an hourly basis. Compression- apply compression to prevent excessive swelling. Elevation- will help reduce the accumulation of interstitial fluid and off-loading the injured leg. For example, you should lye flat on your back and raise your foot. During this initial phase your physiotherapist will advise you on appropriate range of movement exercises to complete.
Everyone’s injury is specific to that person, and your physiotherapist will create an individualised rehabilitation programme to suit your needs. Furthermore, each athlete has different post-injury sporting goals, level of skills and degrees of competitiveness, all of which influence the rehabilitation process.
Following the initial stage of muscle strain management which is described above your physiotherapist will progress to muscle conditioning which includes- muscle activation and motor re-education, muscle strength, muscle power and muscle endurance.
Regaining full flexibility of the muscle and affected joint is an essential component of the rehabilitation process. Restoration of neuromuscular control (proprioception and balance) which describes nerve impulses orientating joints, muscles, ligaments and tendons, which are then processed by the central nervous system to provide information about joint position, motion vibration and pressure. Retaining this system is important for future injury prevention.
Once sufficient level of strength, power, endurance, flexibility and neuromuscular control has been achieved, the athlete will then be gradually re-introduced to functional activities associated with his/her sport. Basic functional exercises include walking, jogging progressing into agility exercises.
In addition, following graduated training of functional activities, sports specific skills acquisition is the next phase in rehabilitation. For muscles that have not been subjected to performance level of stress for some time for instance, your rehabilitation programme must be progressed gradually through sports specific tasks of increasing difficulty. To ensure substitution patter and compensatory movements do not occur it is important you focus on your technique and form.
The previous rehabilitation stage of skill acquisition leads very nice onto the final phase of return to sport. This may be a staggered return to previous volume and intensity of training and competition. This prepares the athlete for complete return to competition.
Here at Ballsbridge Physiotherapy Clinic, we have a team of chartered physiotherapists to assist you either during your recovery. From acute injury management, soft tissue management, biomechanical assessment and training analysis, our sports specialists Olive and Dave can recommend the course of action to suit your needs best. To book an appointment, contact the clinic here.