1. Quadriceps Strains

2. Predisposing Factors Contact Sports Any cardiovascular problem that leads to decreased circulation Obesity Poor nutrition Previous thigh injury Poor muscle conditioning Muscle fatigue

3. Mechanism of injury Prolonged overuse Violent single blow Tension forces on the quad muscles causing an overstretch

4. Signs and Symptoms Pain with knee extension and passive stretch Muscle spasm Swelling Loss of strength Crepitation Point tenderness over injury site Ecchymosis Defect in the muscle (third degree)

5. Examination and Evaluation Palpation –Rectus femoris –Vastus lateralis –Vastus medialis –Vastus intermedius

6. Examination and Evaluation Muscle Testing –A, RROM Knee Extension –A, RROM Hip Flexion –Passive stretch quadriceps muscle (combined knee flexion and hip extension)

7. Classifications Mild (Grade 1) – Slightly pulled without tearing of muscle tendon or fibers. No loss of strength Moderate (Grade 2) – Tearing of fibers in the muscle, tendon, or attachment to the bone. Strength is diminished. Severe (Grade 3) – Rupture of muscle- tendon-bone attachment with separation of fibers. Requires surgical repair

8. Referral/Diagnostic Procedure Orthopedic surgeon – for third degree. for third degree.

9. Treatment and management Cryotherapy – knee flexed positon Cold whirlpool NSAIDSUltrasoundMassage

10. Rehabilitation Stretching Isometric muscle contraction – Quad sets Straight leg raises Knee extensions Abduction exercises Adduction exercises PNF

11. Protection and Return to Competition Factors Sport specific strength and conditioning program Warm-up and cool-down Protective equipment such as thigh pads Neoprene sleeve for compression and support

12. For More Information http://www.injuryupdate.com.au/quadrice ps_strain.htm http://www.injuryupdate.com.au/quadrice ps_strain.htm http://www.sportsinjuryclinic.net/cyberthe rapist/front/frontthigh/quadstrain.htm http://www.sportsinjuryclinic.net/cyberthe rapist/front/frontthigh/quadstrain.htm http://www.worldortho.com/oxsportsmed/ chapt11.html#part5 http://www.worldortho.com/oxsportsmed/ chapt11.html#part5 http://www.mdadvice.com/library/sport/sp ort183.html http://www.mdadvice.com/library/sport/sp ort183.html