Physiotherapy for a Pulled Quadriceps Muscle
The quadriceps is responsible for bracing the knee against the bodyweight in normal walking, stair climbing and getting up and down from a seated position. Tears can be very disabling for a short time until the pain recedes enough to function more normally. Let''s take a person who falls down a couple of steps and places their foot firmly as they fall, meaning the quadriceps is contracting as the knee is being forcibly bent by the force of the body weight. A sudden tearing feeling and a very sharp pain will be the initial result, with the person sitting on the ground holding on to their thigh muscle just above the knee.
After the initial intense pain the area will settle to a strong ache with the return of the sharp pain on any stressing of the now injured area. Getting up into standing will be tricky as the knee will not tolerate being bent as this will stretch the newly injured muscle, so the person will have to turn over and get up on the other leg, pulling up with the arms on something nearby. Provided the tear is not too big the person will be able to walk but will have to watch slopes, steps and any uneven ground as the knee will only bear weight when the joint is straight, which relaxes the quadriceps and takes the stress off.
Rest is important for a few days, at least a reduction in the normal physical activity for the person, although there is no real question of continuing normally as the injury won''t permit it. While ice may be useful the cooling effect may not penetrate very deeply and have little effect inside the damaged muscle, so compression is the first line treatment of most usefulness. An elasticated crepe bandage can be strapped round the area firmly to reduce the amount of tissue fluid which escapes into the tissues thereby limiting swelling and inflammation.
Gradual increase in knee bend is useful to encourage healing in the correct direction but loading of the knee in stairs may be difficult for a week or so. The physiotherapist will encourage regular gently quadriceps contractions, gentle knee flexion, massage of the area and a graded increase in activity every day to return to normal function asap. After the pain has settled the muscle may need to be stretched to ensure normal muscle length and prevent re-injury.
Author: Jonathan Blood-Smyth