Thigh Strain Treatment

The aim of Thigh strain treatment is to reduce pain and inflammation and includes cold therapy, rest, taping, bracing, and massage.

The following treatment methods form part of our full rehabilitation program created by elite sports physiotherapist Paul Tanner.

Program Author

Paul Tanner is head of Medical Services at Millwall Football Club, dealing with all aspects of match and training day sports physiotherapy and medical cover.

Paul Tanner

We recommend seeking professional advice if you are unsure before attempting any rehabilitation exercises.

Who is this Thigh Strain treatment program suitable for?

This program is suitable for anyone suffering from a mild to severe thigh injury. If you suspect you have a severe grade 2 or 3 strain then we recommend you seek professional advice before attempting any rehabilitation exercises.

Program structure

Our Thigh Strain treatment program consists of five phases and one maintenance phase. In order to progress to the next phase, you must reach specific exit criteria. So whatever type of injury you have, you begin at phase 1 and work through each phase.

Thigh Strain treatment phase 1

The aim of phase 1 is to reduce pain and inflammation and allow the muscle to heal. Treatment during this phase is to apply the PRICE principles of protection, rest, ice, compression and elevation.

Rest

Complete rest from running. However, it is important you do other stretching and strengthening exercises as long as they are not painful.

Cold therapy & compression

Apply cold therapy and compression for 10 mins every 2 hours, or a minimum of 3 times per day. Do not apply ice directly to the skin as it may cause ice burns.

Taping/bracing

Wear a compression bandage or thigh support. This supports and protects the muscle and helps reduce swelling. Use arnica-based cream under the compression.

Some physios prefer to use tape to strap the thigh. Taping generally provides more support in the short term. However, it does need to be re-applied regularly and is more expensive long term.

DO NOT:

  • Continue to train as your leg will take longer to heal
  • Apply heat as this increases internal bleeding and swelling
  • Use massage, other than lightly applying arnica-based creams

Exit criteria

To move on to phase 2 you must:

  • Complete rest for at least 3 days
  • Apply PRICE principles min 3 x per day for 2-4 days
  • Walk pain-free for 15 mins
  • No pain to touch
  • Pain-free on standing quad stretch (standing and prone position)

Thigh Strain treatment phase 2

The aim of phase 2 is to continue to protect the area and improve the condition of the muscles. Register here for full access to phases 2, 3, 4, and 5. Phase 2 comprises:

  • Cold therapy
  • Taping & bracing
  • Massage
  • 5 stretching & mobility exercises
  • 2 activation exercises
  • 5 strengthening exercises
  • 2 functional exercises
  • Cardiovasular fitness

Phase 2 exit criteria

You are ready to move on to phase 3 when:

  • Your thigh is pain-free to touch
  • Isometric quad contractions are pain-free
  • Quad stretches are pain-free
  • You can use a stationary bike comfortably
  • You can do a double-leg bodyweight squat without pain

Thigh Strain treatment phase 3

Phase 3 comprises:

  • Hot & cold therapy
  • Taping & support
  • Massage
  • 6 stretching exercises
  • 6 strengthening exercises
  • 5 optional strengthening exercises
  • 3 functional exercises
  • Running progressions

Exit criteria

Move onto phase 4 when:

  • Pain-free through all exercises
  • Pain-free single-leg squat
  • No pain when jogging or 24 hours after
  • No pain to touch
  • You have 70-80% strength injured compared to the good side

Thigh Strain treatment phase 4

Phase 4 comprises:

  • Hot & cold therapy
  • Taping & support
  • Massage
  • 5 stretching exercises
  • 8 strengthening exercises
  • 4 plyometric exercises
  • Running progressions

The aim of phase 4 is to increase quadricep/thigh muscle strength and endurance and prepare for a return to higher intensity running/early training.

Check the Exit Criteria to see when to move to phase 5.

Exit criteria

Move on to phase 5 when:

  • Pain-free through all exercises
  • Runs with no pain
  • No pain post-run (24hrs)
  • No pain on touch
  • Strength is 80-90% of the uninjured side

Thigh Strain treatment phase 5

This is the late rehabilitation/return to normal training phase and comprises:

  • Hot & cold therapy
  • Bracing & support
  • Massage
  • 1 stretching exercise
  • 7 strengthening exercises
  • 2 plyometric exercises
  • Running progressions

Check the Exit Criteria to see when you are at a level to complete the program.

Exit criteria

This is the late rehabilitation/return to normal training phase and comprises:

  • Hot & cold therapy
  • Bracing & support
  • Massage
  • 1 stretching exercise
  • 7 strengthening exercises
  • 2 plyometric exercises
  • Running progressions

Check the Exit Criteria to see when you are at a level to complete the program.

You have completed this phase when

  • Pain-free through exercises
  • Functional drills pain-free
  • Pain-free plyometrics
  • Run without any pain
  • Running at speed (or 24hrs after) with no pain
  • No pain on touch
  • Strength is equal in both legs

However, we strongly recommend you continue to include some of the exercises from the previous phases as part of your normal training routine. This will mitigate the risk of your thigh strain recurring.

Access the full Thigh strain treatment program on our mobile app

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