Acute phase treatment of quadriceps strains is focused on minimizing bleeding into the muscles by following the RICE principle (rest, ice, compression, and elevation). Allowing the muscle to rest prevents worsening of the initial injury.
Full Answer
What is a quadriceps contusion and how is it treated?
A quadriceps contusion is an injury to the quadriceps. This group of four muscles is at the front of the thigh. They help you straighten your knee and flex (bend) your hip. They're important for many movements, including walking and running. With rest and proper treatment, most people get better from a quadriceps contusion within a few weeks.
What is included in the initial treatment of a contusion?
Limb immobilization with rest, ice, compression, and elevation (RICE) should be performed for the first 24 hours in patients with minor contusions and for 48 hours in patients with moderate or severe contusions.
What is the acute phase treatment for quadriceps strain?
Acute phase treatment of quadriceps strains is focused on minimizing bleeding into the muscles by following the RICE principle (rest, ice, compression, and elevation). Allowing the muscle to rest prevents worsening of the initial injury.
What is included in the physical exam of a quadriceps injury?
After obtaining a thorough history, a careful examination should ensue including observation, palpation, strength testing, and evaluation of motion. Strain injuries of the quadriceps may present with an obvious deformity such as a bulge or defect in the muscle belly. Ecchymosis may not develop until 24 h after the injury.
What is the best treatment for a quadriceps contusion?
TreatmentWrap thigh with a wet bandage to insulate skin (ace bandage).Frequently ice the injury for 10-30 minutes.Use crutches for second and third degree contusions.Isometric exercises while using ice will control hemorrhaging.Stretching.A thigh sleeve or "donut pad" are often helpful on return to play.
What is the immediate treatment for a contusion?
Initial treatment for contusion should include rest, icing the affected area for 20 minutes, and applying a compression wrap to help minimize swelling. If there is an accompanying open wound, keep the area clean and bandaged.
When managing a quadriceps contusion What position should the leg be in?
Immediate Management The thigh should be rested in an elevated position with an ice pack applied for 20 minutes every two hours (never apply ice directly to the skin). A compression bandage should be applied to limit swelling and bleeding in the injured area.
What is the best position to ice someone with a quad contusion?
Immediately after the injury, put ice or a cold pack on the injured area of your thigh for 20 minutes. Put a thin cloth between the ice and your skin. While you apply ice, lie on your back.
How do you treat a muscle contusion?
TreatmentRest. Protect the injured area from further harm by stopping play. You may also use a protective device (i.e., crutches, sling).Ice. Apply ice wrapped in a clean cloth. ... Compression. Lightly wrap the injured area in a soft bandage or ace wrap.Elevation. Raise it to a level above the heart.
How do you treat a bruised leg?
AdvertisementRest the bruised area, if possible.Ice the bruise with an ice pack wrapped in a towel. Leave it in place for 10 to 20 minutes. Repeat several times a day for a day or two as needed.Compress the bruised area if it is swelling, using an elastic bandage. Don't make it too tight.Elevate the injured area.
What is a quadriceps contusion?
A quadriceps contusion is a traumatic blow, a deep bruise to the anterior lateral or medial aspect of the thigh. If examination confirms an area of swelling and tenderness with (terrible) pain on passive stretch and active contraction, the diagnosis is a Quadriceps contusion with resultant hematoma.
Why is it important to treat a quadriceps contusion conservatively?
Because it is not possible to foresee how much bleeding will occur in the muscle, it is best to treat moderate thigh contusions conservatively.
How do you treat a quad strain?
Pain reliefRest. Avoid doing activities that may aggravate your injury. ... Ice. Use a cold pack for 15 to 20 minutes every 2 to 3 hours throughout the day. ... Compression. Consider bandaging your thigh with an elastic wrap to limit swelling and movement.Elevation.
How do you wrap a thigh contusion?
Place a piece of foam or paper directly above the injury site. This gives additional compression. Start wrapping the bandage from below the injured area, and finish slightly above it. The compression bandage should be as tight as possible without cutting off blood circulation.
How do you stretch a quad contusion?
Keep your knee straight. Lean forward, bending at the hips until you feel a mild stretch in the back of your thigh. Make sure you do not roll your shoulders and bend at the waist when doing this or you will stretch your lower back instead. Hold the stretch for 15 to 30 seconds.
What should be included in a quadriceps test?
Strength testing of the quadriceps should include resistance of knee extension and hip flexion.
What is the most common type of quadricep injury?
Contusion injuries to the quadriceps are common in athletics. In fact, next to muscle strains, traumatic muscle contusions have been reported as the most frequent type of quadriceps injury in sports [20]. A direct blow to the quadriceps causing significant muscle damage is the usual mechanism of this injury.
What muscle group is the quadriceps muscle?
The quadriceps muscle group is composed of the rectus femoris, vastus medialis, vastus lateralis, and vastus intermedius. The rectus femoris originates at the ilium, thus crossing both the hip and knee joint along its course. This anatomy allows for hip flexion and knee extension.
Where is the pain located in the quadriceps?
Location of pain can be anywhere along the quadriceps muscles, but is classically described along the distal portion of the rectus femoris at the musculotendinous junction. However, several studies have shown quadriceps strains commonly occur at the mid to proximal portion of the rectus femoris [1, 2, 5].
Which muscle is most commonly strained?
Of the quadriceps muscles, the rectus femoris is most frequently strained [1–5]. Several factors predispose this muscle and others to more frequent strain injury. These include muscles crossing two joints, those with a high percentage of Type II fibers, and muscles with complex musculotendinous architecture [1, 2, 6, 7].
What nerve innervates the quadriceps?
Innervation of these muscles is by the femoral nerve. The quadriceps are primarily active in kicking, jumping, and running. Quadriceps strains. Acute strain injuries of the quadriceps commonly occur in athletic competitions such as soccer, rugby, and football.
Can corticosteroids be used for contusions?
Similar to muscle strains, corticosteroids are not recommended in the treatment of contusion injuries. Return to sports. Criteria are similar to muscle strains for return to sports in contusions of the quadriceps.
What are the symptoms of a quad contusion?
Symptoms. Common symptoms of a quad contusion include pain at the site of impact, bruising, and decreased range of motion, which may cause difficulty walking. Swelling and deformity of the muscle may also be noted.
Can a sports medicine doctor do an X-ray?
A sports medicine physician may use diagnostic ultrasound to visualize muscle fibers. An X-ray may or may not be needed depending on what the doctor finds during the physical exam, and very rarely will magnetic resonance imaging (MRI) be needed.
What is a severe contusion?
A severe contusion will be characterised by rapid onset of swelling and obvious bleeding. Both swelling and bleeding may not be able to be controlled. Movement loss will be severe and difficulty bearing full weight on the affected leg will be apparent.
How long does it take for a contusion to break down?
Bone formation associated with Myositis Ossificans usually ceases after six to seven weeks, at which time the formed bone begins to break down and be reabsorbed by the body.
What is the sport where a hard ball or object may strike the thigh of a player?
as Australian football and rugby, or sports such as cricket, hockey or lacrosse where a hard ball or object may strike the thigh of a player.
What is the best way to reduce swelling in a swollen area?
A compression bandage should be applied to limit swelling and bleeding in the injured area. The No HARM protocol should also be applied – no heat, no alcohol, no running or activity, and no massage. This will ensure decreased swelling and bleeding in the injured area.
How long should a soft tissue injury be treated?
RICE protocol should be followed for 48–72 hours. The aim is to reduce the bleeding and damage in the muscle.
How many times can you do quad sets?
These are isometric contractions of the muscle. The athlete tries to make the muscle flex and holds for 10 seconds, repeating 30–60 times, three to five times daily.
Is sports medicine a substitute for medical advice?
The information above is general in nature and is only intended to provide a summary of the subject matter covered. It is not a substitute for medical advice and you should always consult a trained professional practising in the area of sports medicine in relation to any injury. You use or rely on the information above at your own risk and no party involved in the production of this resource accepts any responsibility for the information contained within it or your use of that information.
What is a quadriceps contusion?
A quadriceps contusion is an injury to the quadriceps. This group of four muscles is at the front of the thigh. They help you straighten your knee and flex (bend) your hip. They're important for many movements, including walking and running.
What happens if you have a contusion in your quadriceps?
In a few cases, a quadriceps contusion can lead to other problems, including: Compartment syndrome: This is when blood builds up inside the muscle sheath in the days after the injury. It needs treatment right away to prevent permanent muscle damage. Myositis ossificans: This is a hardening, or calcification, of the muscle.
How long does it take for a quadriceps contusion to heal?
Most people heal from a quadriceps contusion within a few weeks. Rarely, some need surgery if the contusion is very severe or doesn't get better with treatment.
How to help quadriceps with ice?
Put a towel between the ice and the skin to protect it from the cold. Use an elastic wrap to help support the quadriceps and keep swelling down. Take medicine for pain, such as ibuprofen (Advil, Motrin, or store brand) or acetaminophen (Tylenol or store brand).
What are some examples of thigh pads?
For example, wear thigh pads for hockey and football. Know the rules of your sport and follow them. In a football game, you wouldn't want someone to ram his helmet into your thigh, so make sure you don't do it to another player. With skiing, snowboarding, and skateboarding, know your limits.
Can you get an MRI if you have a contusion?
Usually no testing is needed. If the injury is serious or doesn't get better after treatment for a few weeks, the doctor may order an MRI scan. This lets them get a closer look at the contusion and check for other injuries.
What is a quad pull injury?
A quadriceps strain, also known as a quad pull or thigh strain, is a relatively common running injury. Strains can range from a mild discomfort to a full blown tear of most of the muscle which can result in severe pain and the inability to run or walk. The injury typically happens when one or more of the quadriceps muscles become overloaded.
How to protect a site from injury?
Initially, you may choose to “protect” the injury site. This may include the use of crutches to assist with walking. Even using a simple ACE wrap is a method of protecting the site from further injury. Refrain from an activity that may have caused the injury. Avoid aggressive stretching.
What muscle is most likely to be injured?
The most common muscle to injure is the rectus femoris as it crosses both the hip and the knee joint (where the others only cross the knee joint via the patellar tendon). In the case of a quadriceps injury, there is a strain (which is a small tear of the muscle). Like sprains, strains are also categorized as Grade I, II, or III.
What muscles are not warming up?
Not warming up prior to exercise. Tightness in your hip flexors or quadriceps muscles. Weakness in your glutes/buttock muscles. Performing activities that are above your ability level. Performing tasks that your quadriceps muscles are not accustomed to or haven’t performed before.
How long does a sprain last?
Depending on the severity of a Grade I or mild Grade II strain, the initial acute protection phase may last anywhere from three to five days and up to two weeks.
Can you use a tennis ball to mobilize your hips?
You may also utilize a tennis or lacrosse ball to mobilize the deeper hip and buttock muscles or to more deeply and aggressively mobilize the restricted areas appropriately. Take caution with any mobilization directly over the site of injury. This is healing tissue, and it needs to be treated like a healing scar.
Can you stop training if you have a grade II strain?
A Grade II or III strain will be severe enough that you will have to stop training or competition. Grade II tears can often be rehabilitated as well although the healing time is longer. Grade III tears may require surgical intervention.
Definition/Description
Clinical Relevant Anatomy
- The Quadriceps femoris is a hip flexor and a knee extensor. It’s located in the anterior compartment of the thigh. This muscle is composed of 4 subcomponents: 1. Rectus femoris 2. Vastus medialis 3. Vastus lateralis 4. Vastus intermedius
Epidemiology/Etiology
- Quadriceps contusions are mainly common by contact sports like rugby, football, basket, kick boxing . A systematic review resulted in a frequency from 10% to 40% of all football injuries were categorized as contusion, strains or sprains.The injury is caused by a sudden force to the quadriceps muscle causing significant muscle damage. This force is usual due to another playe…
Risk Factors
- Contact sports and sports that require quick starts, i.e. running races and other track events.
- Warm up and cool down habits.
- Off season/preseason/season training habits.
- Poor muscle conditioning.
Clinical Presentation
- A massive blunt force mostly to the anterior or lateral thigh causes rupture to the muscle fibers. In the beginning there are negligible symptoms, but after 24 hours this will lead to hematoma formation within the muscle causing: pain, swelling, stifness and impairment of functional quadriceps excursion.
Pathophysiology
- The injury consists of a well-defined sequence of events involving microscopic rupture and damage to muscle cells, macroscopic defects in muscle bellies, infiltrative bleeding, and inflammation. The repair of the tissue can be thought of as a race between remodeling and scar formation. Several physiological responses may occur after a deep thigh contusion including: • …
Classification
- Next to muscle strains is traumatic muscle contusions the most frequent type of quadriceps injury in sports. A direct external forceful blow to the quadriceps causing significant muscle damage is the usual mechanism of this injury. In comparison to strains, contusions will cause rupture to the muscle fibers at or directly adjacent to the area of impact. This typically leads to h…
Diagnostic Procedures
- The diagnosis is made by questioning an accurate history from the patient and completing a physical examination.
Outcome Measures
- The ‘Lower Extremity Functional Scale’ is used to evaluate the functionality for a wide range of lower limb conditions to know whether the person is having any difficulty with certain activities.
Risk
Prevention
Signs and Symptoms
Immediate Management
Rehabilitation and Return to Play
- Light stretching should be utilised immediately post injury. This will help reduce muscle spasms and make stretching more beneficial in the days to come. Utilise standard quadricep stretching techniques with the hip flexed and extended. These should be performed with a 10 second hold of the stretch, repeated three to five times daily. Another early...
Acknowledgements
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