A thigh strain or quadriceps strain is a tear in one of the quadriceps muscles at the front of the thigh. It can range from mild discomfort to a full-blown tear of most of the muscle.
On this page:
- Causes & anatomy
- Treatment & rehabilitation
Thigh strain symptoms
- Typically you will feel a sudden shart pain at the front of the thigh.
- You may have some swelling depending on the type and severity of injury.
- Thigh strains are graded 1 to 3 depending on how bad your injury is.
- A grade 1 is mild and a grade 3 involves a complete or near complete tear of the muscle.
Read more on thigh strain assessment & diagnosis.
Quadriceps strain causes & anatomy
The quadriceps muscles are the large muscles at the front of the thigh. They consist of the vastus lateralis, vastus medialis, vastus intermedius, and the rectus femoris. A strain is a tear in the muscle. These can range in severity, from a very small tear to a complete rupture.
Quadriceps muscle strains usually occur during activities such as sprinting, jumping or kicking. You are more likely to sustain injury if you haven’t warmed up sufficiently.
Any of the quadriceps muscles can tear, but probably the most common is the rectus femoris. This is because it is the only one of the four muscles which crosses both the hip and knee joints. Therefore this makes it more susceptible to injury.
Quadriceps muscle strains usually occur at one of two locations in the muscle:
Musculotendinous junction (MTJ) strains
This is where the muscle joins/becomes a tendon, which then attaches to bone. This is most likely to occur just above the knee.
This is a tear higher up your thigh, in the belly of the thigh muscle, nearer the hip. This is commonly known as a ‘bulls-eye’ lesion.
Other injuries to the thigh muscles include:
- Injury to the rectus femoris tendon will be felt at the origin of the muscle at the hip. This can be a tenon strain (tear), or can also be an overuse/inflammation type injury.
- Injuries that occur following a direct impact on the muscle, such as being hit by a ball or other hard object, are more likely to be contusions and should be treated slightly differently.
Thigh strain treatment & rehabilitation
For information only. We recommend seeking professional advice before beginning and rehabilitation program.
What can the athlete do?
Initial treatment for a thigh strain should be to apply the cold therapy PRICE principles of protection, rest, ice, compression, and elevation.
- Protect the injured muscle by wearing a thigh support or compression bandage.
- Rest from all sporting activities in the early stages of healing. Continuing to train on an injured muscle will prevent it from healing properly. Elevation of the injured limb should also be done in the early stages and this is best achieved by lying on a sofa with the leg resting up on 2 pillows.
- Ice – apply ice or better still a cold therapy and compression wrap for the first 72 hours after injury. Apply ice for 10 minutes every hour initially reducing the frequency as symptoms improve. This will help stop internal bleeding and swelling and hopefully limit the extent of the injury. After the initial acute stage treatment will depend on the severity of the injury.
- Compression will help reduce swelling and protect the area.
- Elevate the injured leg to help swelling and tissue fluids flow away from the site of the muscles strain.
What can a professional therapist do?
- A professional therapist can make an accurate diagnosis.
- They will advise you on treatment and a full rehabilitation program.
- They may also use electrotherapy such as ultrasound to aid the healing process.
- Use sports massage, especially after the acute stage has passed.
Sports massage may be beneficial after the initial acute stage has passed. Massage helps to increase blood flow to the muscles, which aids the healing process. Massage helps improve your flexibility and loosens any tight knots or lumps following injury. It is also thought to realign scar tissue and improve tissue elasticity.
Thigh strain exercises
After the initial acute stage of the injury has passed, a gradual rehabilitation program consisting of stretching and strengthening exercises should begin.
Stretching exercises should always be pain-free starting with gentle static stretches and progress through to more sports specific stretches performed dynamically (with movement). Do not start stretching too early as the healing of the muscle may be compromised (not before day 5 post-injury). The initial active range of motion exercises is done where the knee is bent through as full a range as possible. A simple static quadriceps stretch is done when pain allows.
Read more on quad strain stretching exercises
Strengthening exercises – the aim of strengthening exercises is to gradually increase the load that is put through a muscle. Strengthening exercises can start as early as day 5 as long as they are low-level and must be done pain-free. If it hurts do not do it! Isometric or static exercises are advised first and then progress to dynamic exercises with resistance band and finishing with sports specific running and sprint drills.
Eventually, more sports specific or functional strengthening exercises are done involving sprinting, change of direction and plyometric or hopping type exercises.
Read more on strengthening exercises.
- Hughes C, Hasselman CT, Best TM et al. Incomplete, intrasubstance strain injuries of the rectus femoris muscle. Am J Sports Med 1995;23:500-6
- Gyftopoulos S, Rosenberg ZS, Schweitzer ME et al. Normal anatomy and strains of the deep musculotendinous juntion of the proximal rectus femoris: MRI features. Am J Roentgenol 2008;190(3):W182-6