Symptoms of a quadriceps strain or thigh strain typically consist of a sudden sharp pain at the front of the thigh. A tightness or pulling sensation may be felt.
Swelling and bruising may develop but not in all cases. Thigh strains are graded 1 to 3 depending on how bad the injury is with a grade 1 being mild and a grade 3 involving a complete or near complete tear of the muscle.
Grade 1 thigh strain
Symptoms of a grade 1 quadriceps thigh strain are not always serious enough to stop training at the time of injury.
A twinge may be felt in the thigh and a general feeling of tightness. The athlete may feel mild discomfort on walking and running might be difficult. There is unlikely to be swelling. A lump or area of spasm at the site of injury may be felt.
Grade 2 thigh strain
Grade 2 symptoms are more severe than a grade two. The athlete may feel a sudden sharp pain when running, jumping or kicking and be unable to play on. Pain will making walking difficult and swelling or mild bruising would be noticed. Pain would be felt when pressing in on the suspected location of the quad muscle tear. Straightening the knee against resistance is likely to cause pain and the injured athlete will be unable to fully bend the knee.
Grade 3 thigh strain
Grade 3 symptoms consist of a severe, sudden pain in the front of the thigh. The patient will be unable to walk without the aid of crutches. Bad swelling will appear immediately and significant bruising within 24 hours. A static muscle contraction will be painful and is likely to produce a bulge in the muscle. The patient can expect to be out of competition for 6 to 12 weeks.
Thigh strain assessment
A professional therapist will assess a thigh strain using a combination of techniques including questioning the patient as well as functional tests and assessments.
Assessment of any injury should include questions concerning the patients general health, previous injuries and current injury. The aim of these questions is to determine what may be causing the pain and what treatment is appropriate. The therapist will then perform a physical assessment of the injury to try to determine the source of the pain.
Observation and palpation
The therapist will have a close look at the injured area, observing for swelling and bruising in particular. They should also observe the patient in standing and walking, looking for postural abnormalities.
The therapist will also feel the area for muscle tension, pain and in severe cases, discontinuation of the muscle (a gap where the muscle should be).
Range of motion
Testing the range of motion available at both the hip and knee joints is useful to the therapist as it will provide information about the tightness of the muscles in question, and also if stretching the muscle causes pain. If there is pain on both knee flexion and hip extension then it is likely that the rectus femoris is the injured muscle.
Resisted muscle tests
The therapist should perform tests in which the patient tries to move the leg against resistance. This should be done into both knee extension and hip flexion. If both are painful or weaker than the other side than this suggests that rectus femoris is injured.