• Quadriceps Strain

    (Pulled Quadriceps)


    Quadriceps strain is a partial tear of the small fibers of the muscles that make up the quadriceps group. The quadriceps are the large group of muscles in the front of the thigh. They consist of 4 muscles in each leg that run from the hips to the knees.
    The Quadriceps Muscles
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    A quadriceps strain can be caused by stretching the quadriceps beyond the amount of tension or stress that they can withstand.

    Risk Factors

    Factors that may increase your chance of a quadriceps strain include:
    • Suddenly putting stress on the quadriceps when the muscle is not ready for the stress
    • Using the quadriceps too much on a certain day
    • Experiencing a blow to the quadriceps
    • Doing a strenuous quadriceps activity
    • Sports that require bursts of speed or sudden twists and turns, such as running, jumping, basketball, orfootball
    • Fatigue
    • Tight quadriceps
    • Cold weather
    • Previous quadriceps injury


    Quadriceps strain may cause:
    • Pain and tenderness in the front of the thigh
    • Stiffness and swelling in the quadriceps
    • Weakness of the quadriceps
    • Bruising on the front of the thigh—if blood vessels are broken
    • Popping or snapping sensation as the muscle tears—rare


    You will be asked about your symptoms and medical history, your recent physical activity, and how the injury occurred. Your thighs will be examined for:
    • Tenderness and/or bruising directly over the quadriceps
    • Pain or weakness when contracting the quadriceps, particularly against resistance
    Imaging tests evaluate your leg muscles and surrounding structures. They may include:
    Muscle strains are graded according to their severity:
    • Grade 1—Some stretching with micro-tearing of muscle fibers
    • Grade 2—Partial tearing of muscle fibers
    • Grade 3—Complete tearing of muscle fibers. This may also be called a rupture or avulsion.


    Talk with your doctor about the best treatment plan for you. Treatment depends on the severity of the strain. Recovery time ranges depending on the grade of your injury. Treatment steps may include:

    Supportive Care

    The leg muscles will need time to heal. RICE is often the main part of treatment:
    • Rest—Activities may need to be restricted in the first few weeks. Normal activities will be gradually reintroduced as the injury heals to avoid making things worse.
    • Ice—Ice therapy may help relieve swelling in the first few hours after the injury. Heat or cold may be recommended throughout recovery if they provide benefits.
    • Compression—Compression bandages can provide gentle pressure to help move fluids out of the area.
    • Elevation—Keep the leg elevated to help fluids drain out or to prevent fluids from building up.

    Physical Therapy

    A physical therapist will assess the muscles. An exercise program will be created to help recovery and to strengthen the muscles. If possible, the therapist will also look at what may have caused the injury and recommend changes.


    To help reduce your chance of a quadriceps strain:
    • Keep your quadriceps muscles strong so they can absorb the energy of sudden physical stress.
    • Learn the proper technique for exercise and sporting activities. This will decrease stress on all your muscles, including your quadriceps.
    • Warm up and stretch before vigorous activity.


    American Council on Exercise http://www.acefitness.org

    Family Doctor—American Academy of Family Physicians http://familydoctor.org


    Canadian Physiotherapy Association http://www.physiotherapy.ca

    The College of Family Physicians of Canada http://www.cfpc.ca


    Deleget A. Overview of thigh injuries in dance. J Dance Med Sci. 2010;14(3):97-102.

    Douis H, Gillett M, et al. Imaging in the diagnosis, prognostication, and management of lower limb muscle injury. Semin Musculoskelet Radiol. 2011;15(1):27-41.

    Kary JM. Diagnosis and management of quadriceps strains and contusions. Current Rev Musculoskelet Med. 2010;3(1-4):26-31.

    Muscle strains in the thigh. Ortho Info—American Academy of Orthopaedic Surgeons. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00366. Updated March 2014. Accessed September 16, 2015.

    10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ. Topical NSAIDS for acute musculoskeletal pain in adults. Cochrane Database of Systematic Reviews 2015, (6):CD007402.

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