A quadriceps strain, also known as a quad pull or thigh strain, is a relatively common running injury.
Strains can range from a mild discomfort to a full blown tear of most of the muscle which can result in severe pain and the inability to run or walk. The injury typically happens when one or more of the quadriceps muscles become overloaded.
In this post you will discover the factors that increase your risk of straining your quadriceps, and learn specific strategies to implement during your rehabilitation and return to activity.
How to Recover Quickly from a Quadriceps Strain/Pull
A thigh strain or quadriceps strain is a tear in one of the four quadriceps muscles at the front of the thigh. These muscles consist of the vastus lateralis, vastus medialis, vastus intermedius, and the rectus femoris. The most common muscle to injure is the rectus femoris as it crosses both the hip and the knee joint (where the others only cross the knee joint via the patellar tendon).
In the case of a quadriceps injury, there is a strain (which is a small tear of the muscle). Like sprains, strains are also categorized as Grade I, II, or III. A minor strain is classified as a Grade I tear, whereas a complete rupture, or tear, is classified as a Grade III tear. Grade II tears are partial ruptures or tears. Severe Grade II and Grade III tears cause impaired muscle function and usually have associated bruising that occurs near the site of injury.
With a Grade I strain, you may be able to carry on running at the time of injury. Grade I injuries tend to be mild in that they tend to heal fully. With proper care and rehabilitation, the healing times can be reduced.
A Grade II or III strain will be severe enough that you will have to stop training or competition. Grade II tears can often be rehabilitated as well although the healing time is longer. Grade III tears may require surgical intervention.
Symptoms of a Quadriceps Strain/Pull:
- Sudden sharp pain at the front of your thigh.
- Swelling and bruising may develop.
- A lump, bump or muscle spasms may occur.
- In the case of a Grade III tear, a gap in the muscle may appear and you lose the ability to straighten your knee.
A quadriceps strain most commonly occurs during running or jumping (in particular during sudden movements or when quickly starting and stopping). However, you could just as easily pull your quadriceps while weightlifting, working in the yard or accidently stepping into a hole.
Factors that can increase your risk of straining your quadriceps include:
- Not warming up prior to exercise.
- Tightness in your hip flexors or quadriceps muscles.
- Weakness in your glutes/buttock muscles.
- Performing activities that are above your ability level.
- Performing tasks that your quadriceps muscles are not accustomed to or haven’t performed before.
Initial Treatment
The course of treatment is dependent on the severity of the pain and the location of the injury. Please seek competent advice from a medical doctor, physical therapist or athletic trainer if you’re experiencing severe pain. A professional can assess the severity of the strain and address how to handle the injury.
For the purpose of this discussion, I will address a Grade I or minor Grade II injury. The initial course of treatment following the sprain includes PRICE, which stands for Protection, Rest, Ice, Compression, and Eelevation.
- Protect. Initially, you may choose to “protect” the injury site. This may include the use of crutches to assist with walking. Even using a simple ACE wrap is a method of protecting the site from further injury. Refrain from an activity that may have caused the injury. Avoid aggressive stretching.
- Rest. In this case, rest would indicate tapering down from your regular exercise activity or any activity that involves using your quadriceps (running, weightlifting, jumping or even excessively bending your knee).
- Ice. Apply ice to the painful area. The rule for icing is to apply ice no more than twenty minutes per hour. Do not place the ice directly against the skin, especially if you are using a gel pack style. A bag of frozen peas can be ideal. Individuals with poor circulation or impaired sensation should take particular care when icing.
- Compression helps to prevent and decrease swelling. Swelling can cause increased pain and slow the healing response, so limit it as much as possible. You can utilize a common ACE wrap.
- Elevation. Compression and elevation may not be fully possible if the injury is located higher into the thigh. If there is swelling in the lower leg, then elevating the leg may be helpful.
During this acute phase, gently move the leg as you can tolerate. Don’t be aggressive with the movement. Walking is usually the best way to keep the area moving. Be sure to keep your steps shorter if you are experiencing pain. Keep to level ground. You may also try gently floating or walking in a pool as long as the pain does not worsen.
Depending on the severity of a Grade I or mild Grade II strain, the initial acute protection phase may last anywhere from three to five days and up to two weeks. Continue to monitor your symptoms closely as you progress into the sub-acute phase of treatment. If your pain increases or additional bruising occurs, you will need to taper back off your activity and possibly seek additional advice.
How to Self-Treat a Quadriceps Strain/Pull:
Mobilize the fascia and muscle tissue.
Work on restoring normal pain free movement of the leg. Start with mobilization of the areas above and below the injury site by using a Thera-Band Standard Roller Massager. Please refer to Mobilizations for a Quadriceps Strain.pdf. Be gentle and initially, do not mobilize over the site of injury. As pain decreases and you are tolerating mobilization over adjacent sites to the injury, you can gentle start mobilizing the injured area.
You are likely to experience tightness throughout the lower leg including the buttocks, hip flexors, and IT Band. You may also experience spine tightness or pain due to altered movement patterns in the lower extremity. I recommend using a foam roller to address tightness in the lower leg. Care should be taken, and don’t roll too aggressively on the site of the injury.
You may also utilize a tennis or lacrosse ball to mobilize the deeper hip and buttock muscles or to more deeply and aggressively mobilize the restricted areas appropriately. Take caution with any mobilization directly over the site of injury. This is healing tissue, and it needs to be treated like a healing scar. Initially, it will be fragile, but over time proper mobilization will help increase its strength and robustness.
Stretch
As you progress through your rehabilitation, care should be taken when stretching the quadriceps and hip flexors. I tend to utilize both mobilization and gentle stretching to help maintain quadriceps and lower leg motion. Don’t let the quadriceps become tight and restricted, but don’t be aggressive with your stretching either. The goal is to keep full range of motion in both the knee and hip joints. Pain may initially limit the full motion, but over time progress back into full range of motion.
Initiate a strengthening program
Any injured area will be weak initially. Slowly start progressing into strengthening the injured area. Focus on body weight exercise before returning to any weightlifting activities. Please refer to Strengthening and Rehabilitation Exercises for the Quadriceps.pdf. These exercises are listed easiest to hardest. Once you can easily perform them without pain or discomfort, then progress back into weightlifting activities. This process should be slow and graded.
Hydrate
The human body is primarily made of water, which is critical for all body functions. Hydrate more frequently during recovery. Adequate water intake is critical as your body attempts to heal and flush out metabolic wastes. Dehydrated tissues are prone to injury as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Keep steady supplies of nutrients going to/from the site of the injury. Try to avoid beverages that contain artificial sweeteners or chemicals with names you can’t spell or pronounce. Water is best.
Start a supplement
A quadriceps strain is typically associated with a specific event and an active inflammatory process typically occurs. I am a supporter of natural supplements and remedies. Many supplements include herbs which are designed to help reduce inflammation and support the healing response. My most recommended supplement to help recover from injury is CapraFlex by Mt. Capra. Another option would be Tissue Rejuvenator by Hammer Nutrition.
Protein
Consuming an adequate level of protein is necessary in order to repair injured tissues. I recommend eating additional plant based protein as well as protein from meat sources.
Return to Activity
Once your pain decreases and your hip and knee range of motion has returned to normal, slowly start tapering back into your training routine. During this time, you remain at a higher risk of injury. As you continue working through your rehabilitation and your return to activity, implement the following strategies:
- Warm up prior to exercise. Increase your normal warm up time by at least 10 minutes in order to increase blood flow to the area. This allows for better mobility and also prepares the tissues for exercise. Use a self-massage tool or a foam roller to roll up and down the quadriceps as part of your warm up. If you perform quadriceps and hip flexor stretches, be mindful that prolonged static stretching before exercise may worsen performance. Warm up exercises may include light jogging, bicycling, rowing or any activity to get the heart rate up and the blood flowing in the lower legs. Be careful when performing any movement that puts the hip flexors and/or quadriceps in a stretched positon with speed or force.
- Cool down. After performing your exercise or activity, take the extra time to cool down and stretch. Focus on quadriceps stretching as well as general lower extremity mobility stretches. Use the same self-massage tools as you did during your warm up.
- Initially avoid potential high risk activities. As your recovery progresses and you return to activity, initially avoid high risk activities that put the quadriceps muscle under heavy load or a very quick load. Progress slowly. If an activity begins to cause pain in the quadriceps, don’t push through it. Instead, stop and give your quadriceps more time to heal prior to trying it again. You should be pain free before you progress the intensity of the activity or sport. Quadriceps pulls have a high likelihood of re-injury if you rush the process.
- Regain full strength and motion before returning to sport. Before a full return to sport or activity is initiated, you should have full lower leg and quadriceps mobility and strength without pain. If you continue to experience soreness or restriction, continue to work on your rehabilitation until the leg and quadriceps have returned to normal. Then initiate a full return to activity.
If you’re not experiencing relief and progressing in your recovery after two to three weeks of aggressively managing the symptoms, contact your medical doctor, physical therapist or athletic trainer for an assessment and help in managing the injury. The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area.
For additional information on common running injuries and how to self-treat, please visit www.thePhysicalTherapyAdvisor.com.
Disclaimer: This article is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice. No health care provider/patient relationship is formed. The use of information on this blog or materials linked from this blog is at your own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Do not disregard, or delay in obtaining, medical advice for any medical condition you may have. Please seek the assistance of your health care professionals for any such conditions.
Thank you for your kind words. Good luck on your recovery!
Hello sir. I restarted playing soccer after about 3 years. Playing from 4 day . Today morning i did little more running as usual and while shooting football,i got a sudden pain in my upper thaig , the pain was so severe that i discontinued the game and shifted to my home. Now i have severe pain while walking or any movement. Please help me and say me the name of injury. And recovery time . Please
Hi Mohammed, I cannot give specific advise having no opportunity to evaluate you. But based off of your story it does sound like you may have strained your quadriceps muscle. This may have occurred due to tapering back into soccer too quickly after a long break. A significant strain can take many weeks to recover from. I advise a slow rehabilitation process and then once pain free a slow taper back into soccer, returning back to sport to quickly will only lead to re-injury. The advice in this article should be helpful. All the best! Ben
Thank you very much. I should i recover ?
Hi Mohammed, Recovery from a quad strain is very doable. Just take a slow and easy approach. Ben
Hi Ben- great article I have saved it. My husband ran a lot when he was younger but decided suddenly to start doing sprints. He’s 65 & fit but not lifting or training like was before the pandemic. He heard a pop & could not run but could put weight on it.It swelled & bruised. We did RICE. He thinks it was a grade 2 tear. It has been 3 weeks and it is a little stiff but he feels he’s ready to run but from your article he needs to do a lot before he starts again. My main question is will the small bulge go away & what is it? Is it part of the muscle bulging through torn fascia? Do these types of tears require mri’s or surgury or does scar tissue eventually form & it goes away? He does have low back & stiff hips & because of that always does a lot of static stretching. I tried to get him to do more dynamic stretching.
Hi there. Thanks for the question. Yes, it is likely he had a grade II tear. The bulge can be swelling and scarring that is occurring. It can also be something called Myositis Ossificans. Where the body puts a calcium deposit over the injury. It will eventually go away in either case. But 3 weeks is definitely too early to return to running (especially for someone who was not running a lot pre injury). I wouldn’t start progressing back to running for at least 8 weeks. Follow the guidance in the article. He needs to be pain-free and be able to strength train which he must slowly taper up as well. Running is very dynamic and higher risk. At this point, he would be a very high risk for re-injury. Hope that helps!
Thanks Ben. The bulge isn’t too prominent. I will get him strength training. I did PT for a vmo tear ( weak gluteus medious) & a series of knee strengthening. I assume your pt or that or includes strengthening all the quad muscles. Do you have any insights on turf toe or medial metatarsal impacting the plantar fascia but more in the arch? I was running on gravel in asics and caused this injury. Now I can’t run on anything but flat hard surfaces or the sharp pain felt only when I touch the joint will come back. I wear a running shoe w an arch plate designed for trail running. About 7 mos out & it is 60% better. I do arch and toe exercises w lunges. Thanks!!!!!
Sounds good in regards to the quad tear. For turf toe or metatarsalgia, that is still really painful especially in the joint. Find a skilled manual therapy based PT and have them assess the joint mobility of the toe. Also, sometimes taping the toe pre run to be slightly pulled more laterally can help. Best of luck!
Hi Ben, I desperately need help with an answer. In 2020, as I was doing weighted lunges I heard a loud ripping/tearing sound in my left thigh which caused me to almost pass out from the pain and left me unable to walk without a cane. I couldnt get the MRI right away due to funds and personal reasons. After a couple months, I finally got the MRI which showed NO sign of quad tear. This is conflicting with my severe pain. I have not been able to even attempt running, squatting down my body weight nor even walking without excruciating pain in my mid left thigh. It feels like a sharp knife slicing pain in the muscle and often spasms at rest. Bearing weight on it poses significant pain and stress. What on earth could be wrong? I hope just maybe you could have some answer as to what this sounds like. Thank you.
I’m so sorry to hear about this. I don’t have enough information to offer a strong suggestion. Clearly there was an injury. Did or do you have any back pain in association with this?
Zero back pain. Lately, instead of localized pain I’ve been getting radiating pain from the thigh straight down to the foot it feels like something is crushing it from the inside. I honestly would just like to walk again as it is getting frustrating. Have you no idea off the top of your head at all even closest suggestions? I would take anything at this point. From all of my time invested speaking with consultants the mass majority believe it could be a lumbar injury putting pressure on a nerve to my leg and I am going for another MRI to rule this out. Very peculiar especially hearing such a loud rip and pull in my quad that specific day.
Hi Alex,
It is difficult to diagnosis an injury just from a partial history and no examination. The other common area of injury given the mechanism would be the hip labral area. It should also be screened out as a possible source of the pain.
Hi I think I have injured my muscle vascular in inner part of my quad on my thigh while doing a long run it was almost 2 weeks ago now I’m marathon training an no issue in the run I got up funny after the run when muscles where tight in I had a sharp pain inner thigh to knee I originally could walk on it no I can an I can do most thing training wise but I still can’t run it’s sore and aches straight away when I try to run what will aid recovery and is it normal to feel a little sore when I start back run please help I have a marathon in 5 weeks! And havnt ran because of this for 2 weeks nearly x
It’s normal for some soreness, but not pain. It’s better to go into the marathon under trained and healthy vs injured. I would see a physiotherapist right away if you want the best results going into the race.
Hi Doctor Shatto,am Edward,about 3 weeks ago I got a knock on my thigh muscle just above the knee while playing soccer,the next day it started swelling with a lot of pain,I went to the hospital about a week later and the MRI results showed that I have blood clot and a torn ligament on my knee.
Surgery was performed to remove the clot and repair the torn musle,after 2 days the drain was removed and was allowed to go back home but with stitches and a bundage on. After 2 weeks of recovering I couldn’t bend my knee fully its like I had a locked knee,then I accidentally slid and overstretched the muscle which was so pain full and it started swelling again.
I went back to the hospital but they gave me some drugs and removed the stitches,what can I do to reduce the swelling and be able to atleast bend my knee
Hi Edward….In a case like this I would proceed with caution. It is possible you re-injured the knee and/or re-tore ligaments. You can use Ice (every 20 min), compression and elevation to help reduce the swelling and gentle range of motion such as laying on your back and sliding the heel back and forth to gain more knee mobility. I hope that helps! Best of luck on your recovery. Ben
I have been dealing with quad pain for 12 months. A year ago while playing soccer I overdid and continued activity with a pulled quad. As time went on it was seen on a MRI to have been a grade II strain. An indentation/bump formed after a month and limited range of motion stay persistant. 8 months later spasms are continuing and the second mri shows a huge ball of scar tissue with a hematoma calciification. After a month of deep tissues massages the range of motion continues and when flex the pain is still their in the center of the quad. Any idea of what it could be? Why is the muscle continuing to spasm.
Hi Jay, Great questions. Yes I have seen this before. Typically the hematoma and calcification will go away but it could take well over a year. Please keep in mind this is only general advice as I have not evaluated you. But if the pain continues it is likely due to adhesion and scar tissue from the injury. My advice would be to continue the manual work including massage but to also start a strength training program that is slow and steady and will load the quadriceps muscles through a near full range of motion. This includes a squatting program using a barbell so you can load additional weight possibly weekly. The best resource on this is a book called Starting Strength. In addition, the Resilient Runner program through Marathon Training Academy has an excellent thorough write up on quad strains and a rehab protocol and video. Hope that helps. Best of luck! Here is the link to the Resilient Runner Program. https://marathontrainingacademy.clickfunnels.com/injury1
Ben
Awesome, thank you for the response Mr. Shatto, would you say the reason I am probably feeling as if I pulled it again after activity is due to the scar tissue not being broken? Could it be resulting in cotninuous muscle pulls do the lack of motion? Thanks again
Hi Jay, In my experience the three most likely reason’s to re-pull a muscle are the following.
1. The tissue has not healed fully and this would include an abnormal amount of scar tissue or lack of normal range of motion.
2. The muscle has not or did not regain its full strength so when the muscle is placed under load, particularly in a sport situation is is prone to re-injury.
3. The underlying reason for the original muscle injury has not been dealt with. This includes muscle or strength imbalances that can predispose for an injury or poor technique with sport that can lead to injury.
So address these 3 items before returning to sport to lower your risk of re-injury. In the cases of severe strains it can be 6-9 months.
Hi I’ve been out about 6-8 week with a left quad pull I HVe played with it still kicking a football o have rested last two weeks I can run soon as I put me foot throw the ball that when it hurt how long recovery
Hi Paul, Recovery varies person to person but a severe pull can be 8-12 weeks depending on your sport and how well you rehab. My advice is to progress slowly back to sport as it is easy to re-injure. Best of luck! Ben
rectus femoris strain moderate im 57. mtber..3 months off work. no one knows how to treat this,, NO ONE, if you get this you are done…
Jack….significant strains like this can take a long time to recover from. The goal is to slowly establish full pain free range of motion. Then slowly work on strength. Don’t be aggressive with massage or mobilization particularly over the injury. Only work above and below the injury sight to limit additional inflammation. This is very treatable but it has to be a slow steady approach. Too fast and you will get set back after set back. There is a lot more detailed information in our Resilient Runner Program https://marathontrainingacademy.clickfunnels.com/injury1
Be sure to get more specific advice from someone that specializes in sports medicine if need be. Best of luck on your recovery.
Hey Doc I just got back into soccer after 2 years I played 5 days in a row rested for 2 and played again now I have pain in my thigh I’m not sure what it is
Well, given the long lay off of playing and then the rapid return of 5 days in a row. It’s most likely over use pain. I would advise tapering up more slowly. Ben
I was sportive and start having pain. After seeing alot of doctor and therapy still i suffer from pain. Every doctor told different causes. One of them told i have weak quad which i need to make it strong. Is it ok to do sport such as bodypump?
Thank you
I’m so sorry you are having so much pain. Body pump can be a good form of exercise but weight training will work best for developing strength. Good luck!
Hi Ben. Pulled or tore muscle while playing 5s about 8 weeks ago. Continued to exercise after about a week. No pain at all apart from when kicking a ball. Had physio and went back to playing about 3 weeks ago. At first I felt some pain when shooting, but after my 4th game all seems nearly back to normal.
However I have a large painless lump high up on my leg and seem to have a slight gap below that.
Do you know if this is anything to be worried about, or is it just the muscle still trying to heal?
Hi Mick,
There are a few different scenarios in play here. One option is Myositis Ossificans. Another option is that there is a muscle belly tear such as a grade II or III tear. It is possible it is local swelling and a simple grade I injury. However, I would suggest additional imaging to help guide the rehab process to avoid possible aggravation of the injury. Hope that helps!
Hi Ben, I returned to play soccer after 5 months and then when I was in a shooting drill i felt pain my upper thigh. It hurts me after training for an hour or two and then it just disappears and if i walk or run I dont feel any pain but once i start playing soccer and shoot the ball thats when I feel pain again
Sounds like the injury is not fully healed. In cases like this I recommend focusing on strength training particularly eccentric training. Hope that helps! Ben
Hello Mr.Ben its 8 months ago when i have been injured and still having pain in my outer thigh.My rupture on quadriceps was very big and it took me tl heal around 4 months and after it healed it started having pain in my outer thigh like stabbing with knife,burn,i had and tingling but not anymore etc..I have done and EMG to check for my nerves but its say that they are well.Everytime i training(not 100% i train like 40-50% runing like 10 max 15 min)my outer thigh will have pain. Can you please help me,adivise me cuz im only getting nervous and angry.Thanks.
Hi Agron, a significant tear can take 6-12 months to heal. It could be you are not fully healed. Or it could be you are having IT Band pain from compensation from the injury. Another possibility is that scar tissue is impeding the mechanics of your leg movement. My advice is to make sure your legs (quads and hips) are equally strong and mobile. Focus on strength especially eccentric strengthening. Weight training such as squats are a must. Hope this helps!
Thank you veru much Dr.And one question is it normal to have pain if i train because that worries me i am training like squats,running not so much, doing things wisley but then after that if my leg is tired then starting pain in my outer thigh(sometimss in the end of outer thigh,close to hip and sometimes all outerthigh).
No pain is not normal, but some discomfort is common. Try to minimize the pain as you train. Again pain in this area sounds to be more hip in origin I would suspect some kind of muscle imbalance that is affecting your hip abductor attachments at the greater trochanter (the bone you feel on the out side top of the thigh/hip).
Thanks for this excellent article
I’m 63. I play tennis every day at a competitive level. I do yoga twice weekly and have a tennis-related gym regime 3 times weekly.
I incurred a mild quad strain sprinting for a drop shot when playing tennis. It felt like a knot in the middle front of my thigh. I had no subsequent pain unless I stressed it again. I sipped all of my tennis, gym & yoga and iced the injury frequently as well as treating it regularly with a massage gun.
Now, one week later, I have no pain at all & can’t really feel the knot anymore. I’m wondering if I can resume my activities and to what extent? I’m keen to restart playing but I don’t want to have a recurrence
I’
Hi John,
Great question. In cases like this, I would take a slow graded approach. It’s very easy to re-injure. Start back with yoga for a week, then the gym for a week, and then tennis last. You’re most likely to re-injure playing tennis.
Hope that helps!
Thank-you for all of the detailed information. I typically weight train but did some sprinting while playing baseball with friends and family. Though my quads were tight, I trained as usual and cut out stretching/foam rolling due to a busy schedule. Well, I just strained both quads chasing a paper bag in the wind ha ha! I am hoping that if I follow your guidelines I’ll be feeling better soon 🙂
Geez…….well…….I guess the need for cross training is more important than we think 🙂 LOL. Sorry to hear about the quad strains. Good luck and wishing you a speedy recovery. Let us know if you have questions!
This morning I felt a sharp pain while working out my quads. Right away I knew I have pulled the muscle, stopped the activity, placed ice on the sore area and have rested with my elevated leg most of the afternoon. Still tonight hurts when extending the muscle and walking… After reading your most helpful article have accepted that may not be able to return to the gym at least until next week… Thank you for the detailed information and advice…
Mapi, I am so sorry to hear about your injury. Follow the advice in the article, rest and take it easy for a while and be sure to slowly taper up the activity once you feel able. One of the biggest mistakes after a muscle pull is trying to return to activity too soon without an appropriate recovery time. Again when you start to return to normal exercise and training be sure to taper slowly back up to your baseline. Don’t start back at the prior level right away. Good Luck!
Great article! I’ve been struggling with quad pain while running and after for the last month or maybe even longer. Going to try these steps and see how it goes. Wendy
Wendy….Thank You for the compliment. Let us know how things are progressing and feel free to ask any follow up questions! Good Luck!
Great advice, thank you!
Thanks Cathy!!!
Help. Mine too has lasted 7 months both sides. I cannot walk as the minut I do it comes back though I ripped it again help
Hi Gayle…Severe sprains are easy to re-aggravate. I’m sorry it has lasted so long for you. You have to be very diligent about rehab and return to activity to avoid re-injury. You may want to get advice from a sports medicine professional or you can check out the Resilient Runner program. I have an entire section in there on quad strains and rehab. https://marathontrainingacademy.clickfunnels.com/injury1
hie doc i am experiencing sharp thigh muscle pains which started after i ran a 100m sprint
Hi Ronald,
That does sound like a possible quad strain. Follow the advice in the article and be sure you are pain free and have tapered back into exercise and running before attempting a full sprint. Muscle pulls are easily re-injured. Keep us posted.
Recently this afternoon at dance, I felt a sharp pain in my vastus medialis, and I think I might’ve torn it. I can’t stretch my leg without it hurting, and I have to limp to walk. What is the best thing to do? Would I need crutches? Thank you, and amazing article!
Hi Rayna, Sounds like you may have a strain or a tear. If it is painful to walk then I would recommend crutches. You want to be able to walk normally without pain or a limp, so if you need one or two crutches to do that, then I would do it. Otherwise, don’t over stretch it and just focus on gentle massage, ice, compression and rest as the article advises. Good Luck!
Hi, A month ago I slipped on a wet floor and ruptured my Vastus Lateralis ! I used the RICE technique and the pain went away but very stiff, continued with “gental” yoga. There is still a lump or bump on top of muscle that does not seem to be going. I ‘ve started a walk/run program which seems to work, no pain, good flexibility. I’m 74 years old and a competitive triathlete so should I Expect the healing stage to last longer and should I be concerned about the lump ? It’s about the size of a golf ball and there is no pain when squeezed.
Thanks Tony.
‘
Hi Anthony, Sounds like everything is going well for your recovery. It is always good to get your physicians opinion on the lump. But in my experience it is not uncommon to develop either a hematoma which in these cases is basically dried blood and some scar tissue over the injury site. This is not uncommon and can last for months before the body re-absorbs it. Occasionally the injury site may form a calcification within the muscle at the site of injury. Again no cause for concern. It usually goes away after many months. They are typically not painful and are benign. Either way if the lump is not getting bigger and is not painful it is usually not a concern and is fairly common. As you progress into your run walk program be sure to slowly taper up your strengthening program including quad strengthening. Take Care!
I slipped on wet floor I felt my mucel pull if front of my leg Put ice on and rested this was 3 weeks ago .My leg goes in to spasms is this normal very painful when it does.
Hello there Doc. Great article and thanks for that. I have been stopped by a light strain in the rectus femoris one week ago. Just one month before my half-marathon on 20th of May. I have mainly rest and immobilized for one week and now wanting to recover quickly. not running yet. Do you recommend static bike or could it be convenient normal ciclyng outdoors? Crawl swimmimg maybe not an option due to the flutter kick, correct?
Hi Alfredo, I would start with very gently (low resistance) bicycle riding. I would recommend the static or stationary bike first before riding a traditional bicycle. As far as pool work goes. Though you may want to avoid actual swimming I would still try going to the pool and do water walking forwards, backwards and sideways. When tapering back into activities always start slow then taper up the activity.
Hello doc! So I do pretty intense HIT and spinning 4 times a week. Is it possible to have strained my vastus medialis from overuse? The inside of my right knee is a little swollen and sore as well as a little higher up, but not much. Just wondering what it could be and I am not having much luck finding anything online. Any advice/feedback would be greatly appreciated!
HI Amanda, yes it is possible that the inner quad is bothering you, though you could also be getting symptoms of inflammation from knee related issues. If you are getting swelling then it is your bodies way of telling you to slow down. Swelling like that should not occur after normal bouts of exercise. Be sure you are working on your recovery as hard as you work on your fitness.
Hi there! Thanks so much for this great, detailed info! I strained my VMO 5 days ago while doing an intense plyo workout. I didn’t recognize the severity of the injury at first (lesson learned….listen to my body next time!) So I pushed through the pain and limped around for 2 days before going to the doctor. I’ve been doing RICE, using Tylenol/acetaminophen and using crutches for 3 days with little improvement. How will I know when it’s safe to start walking on it again? Or when I can start stretching? I don’t want to rush it and ruin any progress I’ve made but I’m really looking forward to training again (and walking!!! Lol)
I know from reading your great comments that I should start small and taper up….just wondering how I know when the right time is to start? And what should I start with first? Thank you so much!!!
MD,
Glad to hear the article has bee of help to you. 3 days is not very long for a strain so going slow is advised. As the pain lessens progress down to one crutch and try to walk without a limp. Until you can can walk normal continue with RICE and using crutches. Do not aggressively stretch, only gentle range of motion. Depending on the severity it could be 4-6 weeks before you begin full training again or longer. Pain will guide you, just progress slowly so you can listen to your body. Remember you may not experience pain right away which is why you have to go slow then see how your body responds to the tapered down activity, if all is good slowly taper up a little more the next day. Good luck!!
Hi doc. I had hurt my rectus femoris muscle while doing a shooting drill in soccer. Since then I’ve rested for about 4 months, applied ice and also had physiotherapy sessions too. Now I’ve no problem in running or sprinting but still when I kick the ball with force it still hurts. Can you please tell me why it is happening and some possible remedies. Awaiting your response
Hi Talha, Sounds like you had a tear in the muscle. Though the tear may have healed it may still have weakness. And so the quick stretch and rapid force production of kicking is likely too much for the tissue to handle it, and so you have pain. You need to start a thorough strength training routine with focus on squatting and dead lifting. Here is a link to the best resource on this topic, a book called Starting Strength by Mark Rippetoe. https://www.amazon.com/gp/product/0982522738/ref=as_li_qf_sp_asin_il_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=0982522738&linkCode=as2&tag=thephystherad-20&linkId=7ZGDDT76EHBEZ2NR
Great article, I will make sure to follow these tips through out my recovery. I am having issues with I think is (google assist) the upper part of the Rectus Femoris,right in the hip flexer area is where I feel it the most. The first time I did it which was about a month and a half ago, I was running and I felt a severe pop sensation then my quad basically locked up on me and I couldn’t pick my leg up, bend it, struggled to walk, jump, even getting in and out of the car. I took it easy for that time, stretched a lot then eventually did some light jogging when possible in hope it would strengthen it. Unfortunately the same incident happened yesterday but not as severe.
What should I have done differently? Or do I need to go get it checked out?
Thank you so much.
Hi Duncan, having a medical professional look at it is always a good idea. But mostly likely you did suffer a tear of one of the hip flexor muscles. I am not a fan of over stretching the area so be careful. Initially I only advise walking, ice and rest. Once the initial pain has improved usually 1-2 weeks continue with walking and ice but then start with soft tissue work to the quad to help it relax and heal, I would then start with a very slow but steady strengthening program focusing on the core muscles, pelvis and legs. I would work on this for 6-8 weeks. No running, only pain free cardio such as water walking, stationary bike or elliptical. Then a depending on the severity of the tear a slow taper back into jogging. Again it all is dependent on the severity of the injury and so the timelines can vary a lot. This is a loose outline. Focus on return to pain free range of motion, don’t over stretch it, then work on strength. Once you are stronger than you were pre injury a very slow taper back into running can be done. I have a thorough outline and rehab protocol available as part of the Resilient Runner Program. Here is the link. https://marathontrainingacademy.clickfunnels.com/optin10735340
Hi I pulled my quad muscle at the beginning of June. At the time I didn’t have a specific injury so I kept working out. I go to orange theory about 5 times per week. I’m thinkinf because I have super tight muscles and do not stretch as much as I should is the reason for my Injury. Running maybe. Your article I found so helpful. I’ve been seeing my chiro and doing some stretching foam roller. Haven’t really worked out for a few weeks. My question to u is at orange theory it’s treads/bikes/eliptical. Which one would be the best for me to get back to working out.!!! I’m dying over not being active. I just don’t want to re injure myself. I still cannot run. And how much longer till I’m normal ? Lol any suggestions would be so appreciated
Hi Johnna, I would trial the elliptical first then the rower. I think the style of interval training they do at Orange Theory is good, but remember fitness is not based on cardio exercise alone. You really need to incorporate some strength training to your routine to help insure a complete recovery and to help prevent re-injury. As you start back to exercise you need to slowly taper the activity. I advise no more than a 10% increase in volume per week until you are back pain free. Keep with the foam rolling but don’t over stretch the injury site. Hope that helps!
Great article and really tied together all of the misc things I was reading on the internet. I run and mountain bike, among many other sports, including playing softball. I’m 60 yrs old. Played in a tournament this past week end and running to first base the first time up, my left quad area seized up on me… don’t know if I heard or sensed a pop or what. Just know it hurt. Being the team player (stupid reason probably), I finished that game and 3 others that day. We won the championship and I pitched all the slow pitch unlimited arc games. I could still do a slow “jog” to first on a hit and then get a runner, but infield hits… I was an automatic out. Other than feeling something not quite right with my quad area, I’ve been able to continue to walk, go up and down stairs, mow the grass,etc. Even tried riding my bike because I have a short 10 mile race on trail in a week and wondered how it would “feel”. Seemed to be able to bike fine, with little or no discomfort (maybe a 2 on a scale of 1 to 10). Day after the event, I started getting coloring/bruising on the inside of my thigh; by Tuesday on the top of my thigh including the injured area which seems to be about 8″ or so above my knee area. I iced and compressed on Saturday night, Sunday, Monday and have been doing heat with gentle rolling pin/runners stick over the quad in general and usually not over the actual spot. I have no lumps or bumps or issues moving my knee any way I want to. Possibly a small depression (1/2″ deep?)in one spot in that area. Don’t always feel the depression, but sometimes. Trying to figure out where I’m at with Strain level 1, 2 or 3. Real sure I’m not a 3 with all the functionality I seem to have. The coloration is seeming to fade away some on Weds. Trying to decide about that race on Saturday. What are your thoughts on all of the above and my best course of action. Appreciate any advise you can give.
Hi Ken,
From your description it sounds like a grade II partial tear. The small divot is likely the area where the quad tore and then of course the bruising helps confirm there was actual tissue damage. It is a very good sign that you have been able to stay so active and not have severe pain, but I would caution you to be easy with the area as further tearing could occur which may lead to more pain and significant disability. So from your description I would back off on some of the activity and be a little more conservative. Allow the area to start the healing process then slowly work into a strengthening program. It’s never wise to risk further injury. I would give it at least 2 weeks then slowly start a strengthening program and taper back into activity. Hope that helps some.
Hope you can help Iv been training for the London marathon and about 2 weeks ago I got a pain in the top of my thigh
If I’m seated for 10 minuets then stand the pain is there (only slight pain) then after 10 minuets if walking it goes but I can now only manage about 5 miles of jogging
There is no bruising or swelling just a slight pain on a scale of 1-10 with 10 being the worst I’d say it is a 4
TIA
Hi, thanks for the question. This is very interesting as there doesn’t seem to be a specific incident that occurred. That tells me then the pain is likely from over use. This typically happens either due to a muscle imbalance, an issue with gait mechanics or just increasing running volume too quickly. You are going to have to dig a little deeper and try to find the route cause of the pain. But I would start by looking into one of those three things. A true quad strain or pull will usually have a very specific incident where the person knows that a strain has occurred. Best of luck!
Thank you for your reply
I had a video gait analysis done when buying my running shoes and there was an imbalance so they fitted me with the proper supporting shoes needed for my training
Iv been resting it and it’s slowly getting better I’m just worried that it will happen again
So the question is what was the imbalance/alteration in gait detected and what kind of shoe did they fit you for to correct it? If it was a motion control shoe and you tend to over pronate then it maybe that you have weakness in her deep hip external rotators that needs to be addressed (for example). You could always have a PT evaluation and have him or her give you a home exercise program to address any potential issues they find.
Hello Ben ,I read the your article regarding “How to Recover Quickly from a Quadriceps Strain” and its very helpful .I am suffering from Quadriceps strain from one month and pain increases when ever I play soccer especially while kicking the ball strong .There is no swelling in the leg but there is pain .How long do I need to take rest and can I start playing using ACE Wrap or other bands around my thigh?
Hi Radha, good question. If it hurts to kick the ball then you need a few more weeks recovery. I would think 2-3 weeks then wear the ACE wrap and slowly taper into activities. In the mean time work through the suggestions in the post working on mobility and strength of the quadriceps.
All the best.
Hi Ben, in my left leg I have had multiple ACL injuries. As a result, I often rely on my right leg more due to pain in the left leg. Last weekend, while at a wedding and dancing, I was relying on my healthy right leg a little too much and felt a strain in the right quad. It doesn’t hurt too much, but I do feel weakness in the right quad when walking. However, this morning, while walking the dog, I felt a pull in my left quad muscle near the knee and further up the quad. Is it common for the other (in my case left) quad to experience similar symptoms if it’s compensating for the other (in my case right) quad?
Hi Tim, good question. Yes it can be common to experience pain in other areas either opposite side or just a different muscle group on the same side. This typically occurs due to compensation trying to avoid the injured area, you change how you typically move and the normal alignment of the body and end of straining something else. The most common example of this is hurting a knee or hip causing a person to limp which then leads to low back pain. So for now I would treat both quads and slow down your movements to help normalize any movement patterns while you recover.
Hi Ben, i was doing some soccer training and felt a sharp pain in my vastus medialis .after a few days there was a lump and my leg has started shrinking.its been six months and the pain has not subsided ,what should i do or your recommendation?’
Hi George,
It sounds like you may have suffered a significant muscle tear. If you have access to medical care I would get a physician’s opinion. If you do not have access to care then I would start a very slow but steady range of motion and strengthening program. If the pain worsens then you will definitely need additional assistance. If you can go slow and slowly improve your strength and the thigh starts to gain in muscle bulk you will know you are headed in the right direction. I hope this helps.
Ben
would you please advise on some strengthening programs as i look for a physician?
George,
There are exercises listed in the article. (Please refer to the Strengthening and Rehabilitation Exercises for the Quadriceps.pdf) Once you master these exercises, start a barbell strengthening program that includes squats, lunges, and dead lifts. Start with lighter weights and slowly and progressively increase the resistance as long as there isn’t an increase in pain, swelling or bruising that occurs.
Ben
Hey Ben, I am a 65 year old runner and run about 40 miles a week. For the last two months I have had pain in my right quad on the inside of the leg above the knee. It wasn’t any big deal until the last couple of weeks when it got worse. I’m thinking braking to avoid a collusion on the trail is maybe when I hurt it. It gets really bad if I drive all day in a car between braking and hitting the gas. There is no noticible swelling bruising or anything. Any ideas? Should I tape it, Lay off, and can I possibly ride a bike if I lay off. Any ideas would be greatly appreciated. Larry Stone
HI Larry, Thanks for the question. Its difficult to say just based off that description. If the pain is closer to the knee joint then it is possible that the quad pain is referred from the knee itself. For now I would taper back the running and yes biking can be a good alternative as it provides needed range of motion. Just don’t be too intense with the biking. Thinking of it more like range of motion and improving circulation, not trying to get an intense work out. Give it a week or two then re-evaluate. Also slowly work through the suggestions here or check out my web site or the MTA site and look at Meniscus injury. It might have some helpful advise for you.
Hey Ben, I’m a kicker for my high school team. For the past four weeks my quadricep has been strained including a knot that runs through my mid quad. I took the last week and half off from doing no kicking, went to a physical therapist for treatment which included building up a tolerance level (strengthening), stretching, stem, massage, using foam roller, etc. The only thing that I improved was lessening the size of the knot in my leg. Unfortunately it was still there but very minimal. I guess my question for you is, why do you think the knot it my quad is still there and not going away?
This last Friday I kicked for my team because they needed me and now I’m back to square one with my quadricep strained and the knot in my leg inflamed and irritated. I’m not sure if there’s a partial tear and that’s why the muscle is “knotted up” and refusing to go away…possibly the healing process or only result of no pain is a longer recovery:3-4 weeks. Any suggestions would help
Thanks!
Hi Carter,
Yes, I think you are correct. Likely a partial tear which is leading to the knotting. Kicking too soon will just re-aggravate the injury. The fibers that are growing and repairing are fragile and need time to heal. The muscle simply knots up as a self protection mechanism. So even as the knot shrinks you need to be careful. It may be closer to 4-6 weeks depending on the severity. I would take at least 2 weeks and continue with the PT, then if pain is improving go really slow in your progression of strength training for at least 4 weeks then start kicking, but you will have to slowly progress up to full speed. IF you try to push it too fast you are likely just going to re-injure. What did your PT say?
Ben
They think I should go get an MRI soon…I was able to get some acupuncture done and the specialist thinks that I have a hematoma. He was able to do cupping and acupuncture to bring it to the “surface” to allow it to bruise. If I keep going to pt I think I’ll be able to complete eliminate it and continue to build back strength.
Carter….sounds like you are on the way to recovery. Definitely keep working on strength and be sure to slowly taper back into kicking once the pain and strength has returned. Quickly too hard to quickly can cause re-injury due to the amount of force involved when kicking. Best of luck!!!!
Great article! I strained a quad last week training for a trail race. Doing sprints after a half mile jog. Ran 2 gentle miles after that to see how bad it was. Thankfully it was not too painful after but definitely not right. My race is Sunday and I am nervous because I have not run on it all week. Followed your advice here and I’ve been able to swim and do gentle yoga this week without aggravation. Weight bearing on stairs brings it to my attention but only at a mildly annoying level. Hoping to survive the hills and finish my race without further injury.
Hi Kandi,
Sorry to hear about your injury. I’m glad the article was helpful. You mention that you can feel the strain when going up stairs. That is a sign that the tissue is definitely still injured. If you intend to run the race this coming Sunday you need to make sure you are really warmed up and that the muscle itself stays “warm”. You may consider wearing a compression sleeve to offer support and to keep the area warm. If the weather conditions are cool you will need to take extra caution. In situations like this the rate of re-injury is high, especially if there are hills in the race. Best of luck!!!
Good afternoon Ben!
thank you for this informative article I was looking for more iformation on quads, particularly on vastus medialis.
on November 13th I fell in a garage pit, hit the edge of the pit with my bended knee and landed on my ribs. The injury was more painful on the ribs throughout these weeks, but after three weeks I started to be worried sick about my knee. I wasn’t able to walk, not to mention bending my knee, I can’t lift an extended leg also because if I do it’s so painful in my knee and around it and it feels like something is moving in the knee and there’s cracking sound. but the scariest thing for me that I am not able to move my vastus medialis muscle and it’s still swollen in the area, even the area around my joints is a bit swollen as well. Next week I will make ultra sound examination, because the doctor believes I might have torn the muscle. I can walk now, my other muscles seems to be working, but when I try to bend my leg, the knee area becomes super stiff and a small bump appears near the patella on the inner side as I try and bend it more, so I have to extend my leg quickly because it feels as if that bump will pop out from the skin.
Is it really possible that my muscle is torn or you think there’s another issue (maybe in my knee joint or patella) that is actually triggering it?
Thank you again for this article!
Hi Julia, I’m sorry to hear about your injury. It sounds like you must have taken a very hard fall. From your description it does sound like there could be a significant injury. Based off the information you have provided I would also suspect a possible vastus medialis tear or possibly a fracture of the patella. Either way additional medical follow up should be taken. You wouldn’t want to risk worsening the injury until you know exactly what is wrong. If things were going to improve on their own I would suspect 4 weeks to be long enough. I encourage you to get the follow up so you will have adequate information to know how to progress in your rehabilitation.
Best of luck. After your scan let us know what they find.
Ben
Hello again Ben!
I am here to update about my knee injury. So I went for ultra sound yesterday and according to the doctors who conducted the ultra sound I have a few tears in my vastus intermedius muscle, seemed like the tears are in the muscle belly, not the tendon itself. And the bump on the knee, they believe, is a muscle and it pops out near the patella when I try to extend the knee.
Now I have to wait for appointment with my traumatologist-orthopaedic on December 20th (next Thursday) where he will inform me on possible treatment options.
Do you have any suggestions in the mean time? I try to rest and not bend my leg, I walk very lightly, don’t want to put too much effort on the leg. I also put some muscle pain relief gel, if the muscles get warm I put some ice for a few minutes. I don’t know whether I should wear a knee/leg brace or elastic band since it’s the deeper muscle and it doesn’t really move that much anyway.
Have you ever heard of a vastus intermedius tear? Because, as the doctors mentioned, it’s a very rare case.
Looking forward to your answer and sorry for all the questions, I just find it very frustrating since I’ve never had any serious injury in my life and I am really scared of surgeries.
Thank you!
Hi Julia,
I’m glad you had the ultrasound and they were able to determine the diagnosis. You are correct that this is a more unusual type of injury. The vastus intermedius is deeper into the leg. In most cases the typical treatment is conservative physical therapy treatment. Depending on the severity of the tears it may take many months to fully recover. Typically 3 months or so in therapy and it may be 6 months or so before you are feeling 100% Off course these are just estimates….your personal health status, severity and location of the injury will make a large difference. I would suspect not surgery and conservative management. It just may take a while In the mean time you don’t want to be too aggressive with any movement or activity but if you can alternate heat and ice and do gentle massage and also work on gentle range of motion of the knee. Keep it relatively passive and pain free but you don’t want your knee to get overly stiff if you can help it. Once you start physical therapy and can have a proper evaluation then more specific advice can be given. Best of Luck!!
As a firefighter I suffer injuries from time to time but I strained my quads less than 72 hours ago and I need to recover quickly but I know rest is what I need but any quick fixes?
Hi Aaron, That is a tough one. It really depends on the severity of the strain. You don’t want to overwork the area, but you don’t want to let it get stiff and tight either. If it is a Grade I or small Grade II strain you could alternate ice and heat to promote increased blood flow and use a compression wrap to keep the area supported. If you getting a lot of sharp pain be very cautious. If it is just a dull ache you may get away with a little more activity. But always use common sense. Best of Luck!
Great article! I strained a quad last week training for a trail race. Doing sprints after a half mile jog. Ran 2 gentle miles after that to see how bad it was. Thankfully it was not too painful after but definitely not right. My race is Sunday and I am nervous because I have not run on it all week. Followed your advice here and I’ve been able to swim and do gentle yoga this week without aggravation. Weight bearing on stairs brings it to my attention but only at a mildly annoying level. Hoping to survive the hills and finish my race without further injury
Thanks.
Thank you! Wish you the best of luck on your race. Let us know how it goes!
Hi there,
I am marathon training for a race in May (May 11th) and I think I strained my quad or hip flexor squatting a 45# bar without warming up. There was a sudden pain like a cramp in my right leg on the outside of my quad by the hip. It is still tender to the touch and I’m having trouble lifting my right leg up into a quad stretch position. Air squatting and stretching feel okay but hurt after.
It looks like I need to rest the muscle for at least a week or two, is there anything I can do to keep up cardio conditioning? Is it still reasonable to expect to run a marathon in 3 months time and if so how would you recommend ramping up the running once I am no longer in pain? I am by no means an experienced runner, this would only be my second marathon (my first was last October) so I am quite dependent on my training program to ensure I’m in shape to run.
Thank you!
Hi Michelle,
It does sound like you may have strained the quad. 3 months is plenty of time to get in shape for the race since you likely have a base already having been running and doing a race last October. Take time to rest and work on maintaining the range of motion in the leg. I wouldn’t worry too much about the cardiovascular side of things right now given you have 3 months to train. Focus on getting the leg healthy. Once you can start to jog without pain just tapper back into the running plan. You may start back a few weeks and once your feeling 100% then stair step back into the appropriate week on the plan. In the mean time work on your core strengthening and other cross training that does not cause too much soreness.
Keep us posted!
thanks Ben,
I waited about 10 days from the original injury when I could walk briskly without pain and after a mile warm up I lightly jogged a mile without pain. I rested the next day and then warmed up and tried for two miles. At 1.8 my leg stiffened and then my quad tightened/cramped so badly I had to stop. There was no warning other than the usual(symmetrical) burn from running.
I iced it last night and it still feels tender and sore on the front of my leg and back by the hip. Is It possible that I worsened the injury even though I stopped when it hurt or should I be back to normal once it quiets down? I am uncertain if this is normal or if it means I am attempting too much too soon. Should i go back to resting and light walking for another week (or longer?) before I try to jog again or just wait until the pain subsides and try a more gradual increase?
Thank you!
Hi Michelle,
Based off the information provided it does sound like you re-strained the injury. It depends on the severity but with you re-straining after approximately 2 weeks I would suspect a grade 2 tear. Now grade 2 tears can vary wildly on severity but I would be very cautious with an early return to running. At this point I would target at least 4 weeks of rehab and no running and it maybe up to 8 weeks depending on how it is feeling. Then it has to be a very slow and gradual return to running. But first you have to have full range of motion and pain free use of the leg with squatting and the rehab exercises. Likely tapering up at 1/2 mile increments when you do return to jogging. Going slower now will help insure you don’t continue to re-injury and then have an extended recovery later. I hope that helps!
Ben
Thanks Ben,
Just to confirm that I understand the timeline is it best to wait 4 weeks from today before I try running again or did you mean from the initial injury?
I feel much better after a day of total rest and the quad is no longer tender and walking is pain free.
However, my hips are tender and lower back is sore on both sides, is is possible that I strained that too or is it common to experience tightness due to compensation? I was thinking of scheduling a doctors appointment but the pain is mild enough that is doesn’t seem warranted.
Do you think hip focused yoga would be okay if I avoided painful stretching or should I stick to the rolling mentioned in the article?
I will stick to walking and swimming for now, would the elliptical or biking also be good options or do you think that would be too straining?
Thanks!
Hi Michelle,
It is tough to give specific advice without a thorough evaluation. In general you need to be pain free for several days before you return to running. Especially since it re-strained so easily the first time. The additional muscle soreness is common. During this time try to address any pre-existing issues that may be contributing factors to your injury. I would not over stretch the injury site but I would want to see full range of motion prior to your return to running. I would suggest at least a 2 week break before you taper back into running. In the mean time continue with the rehab including swimming. You could try the elliptical but I would be hesitant about yoga for the short term. The timing is only loose guidelines based on how you feel. But it is always better to taper back into things slowly and not rush. Best of luck.
Hi Ben. I was performing forward lunges in my body pump class when I felt a loud pop at the top front of thigh. As it was near the end of the class I finished off and everything was fine. Did exactly the same thing this week. Loud pop, same place, near end of class. Went home and put ice on. Big red mark where the pop happened and slight swelling. Warm thigh and slight pulling when I walk but no restriction in movement and not really any pain. I thought a loud pop meant it was a grade 3 tear but I have none of the symptoms of this. Any ideas?
Hi Chris, There are lots of reasons to feel or hear a popping sound. If you are feeling this at the the top of thigh I am assuming you are meaning hear the front of the hip or hip flexor area. In this area you can get popping from the tendon as it slides over the bone, or even popping from inside the hip from a small labral tear. If a true Grade 2 or 3 muscle tear has occurred you are likely to not only see swelling but likely bruising and I would suspect there would be loss of motion and pain when using the muscle. My guess based off the information provided is that this is likely a hip /hip flexor issue and not a true quad tear/strain. Hope that helps!
Great article I appreciate your help. I just had the same thing happen today doing walking lunges. What side of the bone should the hip flexor be on the outside or the inside? Thanks in advance
Hi Robert, with a hip flexor strain the pain is most typically in the middle or towards the inner thigh. You may also have some discomfort deep into the lower abdominal area.
I felt something similar today… It was high in front and felt like it moved from center of thigh laterally to the outside. Loud snap I could feel inside. No swelling minimal pain infrequently. Have you found out anything else?
Hi Robert. Snapping and popping in the front of the thigh is very common and often nothing to worry about. A true hip flexor strain will typically be quite painful and will tend to be very tight in the area of injury if you sit for long periods of time. There is rarely significant swelling in this area. Hope that answers your questions. Ben
Hi, Ben. Great article. I believe I have a Grade I/II Vastus Medialis strain/tearon Tuesday (3/26/19). Little background of the event: I was working a strength complex of two push-press and one push-jerk (all heavy weight ~ 90-95% of one rep max), 5 sets of this complex. On the last set, I believe I had 190/195lbs on the barbell, I got the first push-press up with elbows locked out, but on the second one I got the weight up but I think I may have leaned a little too far forward with a lot of the force/weight loading my front quad area. I felt a pop in the mid-quad area, I was able to finish the push-jerk though. The immediate feeling of pain was minimal, maybe 5 out of 10. I continued with the workout which included 6 strict pull-ups, 10 dumbbell snatches, 13 sit-ups for 5 rounds. Since then, I took Wednesday (3/27/19) off and stayed home – I kept my activity real low by laying on the couch/bed with icing the area and elevation. Ive also been applying pressure when ice isnt applied. Icing has been on for 15-20 min every hour. The vastus medialis area is sore, no apparent bulge but there is swelling. It does hurt on the interior side when I try to squat (body weight). Any recommendations on a quicker recovery? I was planning on taking it easy (no lower body workouts) for the next 2-3 weeks.
HI Steven…definitely sounds like a Grade I or even a grade II strain. You need to keep the range of motion in the leg but do not be too aggressive with stretching. It has to be a balance of motion and not too much pain. For the first week or two no aggressive foam rolling but you can definitely massage and foam roll above and below the injury. Continue with icing and compression for at least the first week. Your first goal should be able to perform a partial body weight squat no pain. Then progress to a bicycle with low resistance for the range of motion and to promote blood flow. Be very gentle as you test your limits. If you push too hard too fast it will re-injure and prolong the recovery. Once you can body weight squat (full squat) then slowly start loading the bar. No quick movements like box jumps or wall balls till you are 100% pain free then progress slowly. Depending on the severity this may take 6-8 weeks. If there is any pain with slow movements then definitely avoid quick motions. Typically its a quick motion that will cause a re-injury. Hope that helps!
Hi
I felt a pull on my quad on Wednesday night playing football (soccer) felt perfectly fine after words and never thought anything of it, until Monday night back at football and I felt a much worse pull on the same quad, and it now feels very right and painful, could I have done a lot more damage to myself?
Hi Joe,
Sounds like you had an initial mild strain and likely now re-strained the area but possibly worse. I would anticipate several weeks at least for a recovery and follow the advice in the article. If you push it again it could lead to an even worse injury…..so please be careful as you return to sport. All the best!
Ben
Hi Ben Shatto,
Strains can range from a mild discomfort to a full blown tear of most of the muscle which can result in severe pain and the inability to run or walk. The injury typically happens when one or more of the quadriceps muscles become overloaded.
Thanks.
Hi Ben
Great article. Best I’ve found on the subject. I’m 60 years old, former runner now grounded due to osteoarthritis in both hips.
I’ve started my own stretching and muscle strengthening programme for my hips. One exercise is a straight leg raise with a 1 kilo weight strap on my ankle. I’m really not clear on how often I should do the strengthening exercises but I’ve been doing them 5-6 days a week, 15 reps per leg.
I reckon this is what has caused the pain in my right thigh that occurs after walking about 20 meters and forces me to stop. There wasn’t a dramatic event that caused this. From studying your posts above, I reckon it is the overuse that has caused this.
Two questions:
1. How long would I need to recover from this?
2. How often should I do muscle strengthening exercises?
HI Joe,
Thanks for the compliment. From your description the injury is likely overuse in nature. Because of the nature of the injury there is likely not a lot of muscle fiber disruption but more likely an inflammatory process that is causing more of the pain. I would suspect 2-3 weeks on the short side up to 4-6 weeks on the long side for recovery. This of course assumes that the exercise was the actual source of the pain and there are not other complicating factors. True strengthening exercises do not need to be done more than 2-3 times a week. Though it is critical to engage in some form of activity daily. And daily range of motion is critical for arthritic joints.
Here is a link to another article on hip pain you may find beneficial. Best of luck!
Ben
https://www.marathontrainingacademy.com/hip-flexor-pain
Hi ben, i had a mid thigh muscle strain 3 years ago while sprinting.am an overweight(130kg) young man, had an argument with some guy about who is faster and went straight into the track without warming.its not painful when am walking but whenever i run or put weight on the thigh it starts to lose strength and it sort of starts to cramp.
Hi Sam,
Not entirely sure of your question but it does sound like you may have injured your quad. If it is still bothering you after 3 years it is likely due to a lack of adequate rehabilitation. I would recommend a slow and steady approach to strengthen and mobilize the area, while loosing weight to take strain off the lower extremities. Best of luck!
Ben
Hi ben,
I was doing spin cycling at the gym about one month back and felt a mild pain near the hip specially when im lifting my leg. I saw a doctor later and he told it was a quad strain. I had been resting for a week after, while keeping ice twice a day. i felt normal and could raise my leg without a pain. Then i started brisk walking and got the pain back again while lifting my leg (i can walk without an issue). Does this mean i have re-injured my quad? How long should i rest and how do i know its fully healed?
Hi Mani, Most likely this means the injury has not fully healed and though you are now able to do low level activities the muscle is not yet ready to handle activities that require more load or speed. I would keep with the incing and follow the exercises noted. Every week slowly test your limits to see how you are progressing. But be careful to not over do or you do risk re-injury. Ben
Hi Ben,
My son injured his hip playing soccer back in February. (No “popping” or such that he can remember, just remembers that it hurt.) After the initial injury, he tried to play through for a few weeks but eventually the pain was too great, so he rested for a few weeks. Then he started lifting weights and couldn’t squat and his range of motion was limited, so he went on total rest for about 6 weeks. He tried to slowly resume activity but he was still really uncomfortable with any hip movement, running, squatting, etc.
We saw an orthopedist in June (no MRI) who said it seemed that he had a strained / torn rectus femoris @ the insertion, and prescribed physical therapy. Six weeks of physical therapy, and my son felt better and stronger, got the OK to return to sports in August, almost exactly one month ago. But his hip soon became irritated again, even with frequent icing, wrapping, and lots of stretching — and irritation has turned to pain, and now he is saying the pain is pretty acute. So we’re going back to the orthopedist ASAP, but in the meantime, any ideas? It seems like something isn’t right here.
Thanks so much.
Hi Ruta, Tough questions to answer without actually seeing him, but given how active he is and what activities cause pain I would suspect a possible hip labral tear. Though this would be a guess again without an exam. But it would be top of my list to rule in or out. He definitely needs to be seen by an orthopedist. Ben
https://www.mayoclinic.org/diseases-conditions/hip-labral-tear/symptoms-causes/syc-20354873
Hi Ben, thanks for the informative article!
Quick question – can VMO / Quads injury or tear cause knee pain?
After a night of dancing and jumping, felt dull knee pain accompanied with popping sound on knee extension which stopped me from my sports routine.
It’s been 5 weeks now, and it seems to be improving gradually as the popping sound stopped, but my VMO is very sore to touch. Knee pain when knees pushed together around the VMO and under the kneecap when lunging.
Applied RICE and rested for 3 weeks, then started streching slowly and some strengthening exercises I’m familiar with from Pilates (leg extensions, bridges…)
Trying to understand whether pulled quads alone can cause such pain or is it something additional.
Thanks again.
Hi Uriel, Yes a pulled quad can definitely cause knee pain. However, your mechanism of injury doesn’t entirely fit a pulled quad muscle. I would suspect an additional cause of the injury. If the knee is slowly improving I would continue with your slow and steady rehab protocol. Most knee injuries can be rehabilitated if appropriate time is given. As pain allows and if you have full pain free range of motion you may consider a slow progression of strengthening and balance exercises. If the knee is worsening or not improving you should consider seeking further medical advice. Best of luck.
HI Ben,
I strained my right quad months ago, but it hasn’t fully healed yet. I strained it while kicking a soccer ball back in the beginning of august. Since then the quad started to heal normally, being able to run and exercise with legs. The quad feels healthy and everything, expect when Im trying to play soccer again. I can play basketball at highest intensity possibly, run as fast as I can, lifts weights with my legs normally, but I can’t simply kick a soccer ball without feeling pain in my quad. I don’t know what’s the problem anymore. Obviously I’m going to pay a visit for a doctor, but I’m still curious, why the healing process is taking so many months.
Hi James,
I’m sorry to hear you are still having a lot of pain. Though it has been 3 months in cases of severe injury that is not very long. I realize you are doing a lot of activity now, but force ably kicking a ball involves eccentrically (lengthening) the quad very quickly then exerting a very quick and powerful twitch (kick). This motion puts a lot of strain on the quad, likely more than running or jumping or lifting weights. Mostly likely more time will be needed to fully heal. It is not uncommon for severe injuries to take 6-9 months for a full recovery. One other option maybe an issue with the pelvis. You could have a pelvic rotation or torsion that would place the quad in a poor resting position and predispose it to pain. You may also need to follow up with a hands on specialist that can double check there is no issues going on with your pelvis. Hang in there. You will feel better eventually. It is just a slow road sometimes. All the best. Ben
Thank you for the answer,
I’m relieved to hear that it isn’t uncommon to take so much time to heal quad completely. Thankfully the quad is feeling normal without any pain expect when playing soccer. That was my biggest concern, could I ever even kick a ball normally. It seemed weird that I was and I am still able to do anything normally with my quad while kicking a ball indicates that it hasn’t fully healed yet. If the healing has everything to do with some time in this case, I’m happy to wait it to heal properly 🙂
James happy to help. Yes I would give it a little more time and continue to train and strengthen the area. Revisit kicking every few weeks to see how it is going. Start with lighter kicks and passing drills and don’t progress past this until your pain free. All the best!
Hi Ben,
I run six days a week. I strained my left quad five days ago and been resting since. I’m able to walk fine, and I’m looking forward to getting back to the gym in the next couple of days. Do you recommend starting with the elliptical or stationary bike before I get back into running in two weeks?
Hi again Ben
I was recommended to go to chiropractor who checked if my pelvis and lower back were linked to quad’s problems. My pelvis seemed to be in some position which was affecting my quad. Chiropractor explained that the nerve compression, caused by lower back’s and pelvis’ incorrect positions, was the reason why my quad wasn’t fully healed. Now I just need to go kick a ball some day to see, if the appointment worked. If not, I was recommended to go there once again.
Excuse my name chance, was referring to earlier messages sent under the name James, but autofill decided to replace it :/
I slipped on wet floor I felt my mucel pull if front of my leg Put ice on and rested this was 3 weeks ago .My leg goes in to spasms is this normal very painful when it does.
Hi Susan, I’m sorry to hear about your fall. Sounds like you may have a significant quad strain. If there was a significant tear that occurred it could take 6-8 weeks or longer for a recovery. Take it slow and do your best to keep the leg motion normal and the spasms at a minimum. Wishing you a speedy recovery. Ben
Hi Ben,
I strained my thigh playing pickleball. It hurt for a could of days (I did take care and ice) . By the 3rd day I had no pain walking or moving. So I went back to pickleball (I know, too soon) and did it again, this time very mildly. I’m going to follow your advice and give time to recover. Here is my question – would swimming be ok? (like laps)
Hi Dee, sorry to hear about your injury. Great question: I can’t give specific advise but if you were a client this would be the advice I may offer…..I would first get back to a pain free situation with all regular activities. Then do a trial of maybe just walking in the water forward, backward and sideways. Give it a day and see how it feels. If your fine then a trial of laps would likely be fine though be sure you are thoroughly warmed up and don’t push it too hard at first.
Best of luck!
Ben
Thanks so much Ben. So I’ll wait until walking is completely pain free. It’s pain free this morning (the second strain event happened Wednesday) even walking quickly But I won’t rush to the pool yet. I downloaded your strengthening and rehabbing the quads pdf . The walking in the pool is a great idea. The funny thing is I was completely pain free before even when walking very quickly but it was almost immediately when I started playing again that I pulled it again. I think I will need to be more intentional about getting better! Have a great day.
Sounds like a good plan to me. Just remember to taper back into activity slowly and really be warmed up prior to any vigorous activity. I would consider at least a 10-15 minute thorough warm up cycle. All the best!
Hi Ben – My pain is just above the top of the kneecap, about an inch or so, where’s soft/muscle, about halfway to the outside. I’m guessing near the bottom of the vastus lateralis, but who knows. When I trained for a marathon years ago, I trained on a 100% flat surface and never had this pain, not even preparing with 15-20 mile runs. The marathon race had some easy to moderate hills, so near the end of the race, this area above the knee hurt so bad I thought it was completely broken the pain was so bad. I could walk with zero pain, but trying to run, it was instant pain too unbearable to run. It’s happened several times since, including this week. It seems to occur when incline/declines are involved. I have tried so many modalities to address, from core strengthening, to yoga poses, to consistent stretching (dynamic and status), chiro (including active release technique), pilates, massage, etc., and so far, it’s a mystery, other than I can’t run long distances if hills are involved. No matter how much time I take off and let it heal, as soon as enough hills are involved, even at slow pace running, bam, it returns. Perhaps I am in the 10% of the unlucky peeps who are biomechanically deficient? Or I’m meant to run short distances only, or perhaps the right solution of trying to figure how how to solve it (eg. balanced muscles, etc.) no matter what I do, it just doesn’t seem to help. I really like to run, but this pain keeps me from training on anything but a near 100% flat surface.
HI Chris, I’m sorry to hear this has been such a struggle. In almost all cases there is some kind of biomechanical issue that is causing the problem. It sounds as though you have seem many different practitioners and tried many things. In a case like this I would suggest a change in running mechanics. Potentially try the Chi running technique or something equivalent. Changing your running technique will alter the biomechanical forces on the vastus lateralus and hopefully allow you to run with less pain. Good Luck!
hi ben ,i was diagnosed chondromalacia patella and after afew month i found my vmo muscle in left thigh decreased in mass but without any bruising or swelling i dont know the exact reason is it muscle strain ?? and would it come back to its orignal size what do u recommend for this case
Hi Mero,
The decrease in muscle mass is likely a neurological response to the pain in the knee. This is a very common phenomenon. There does not need to be swelling or bruising present for this to occur. Only pain. The treatment would be to reduce the pain in the knee/knee cap and then proceed with a quadriceps strengthening program trying to avoid as much pain as possible. If the pain in the knee cap persists then a brace such as the NuNee maybe beneficial during the rehabilitation phase and possibly ongoing. Best of luck!
Ben
Hello,
I was playing football the other day and felt a twinge in my upper thigh. I limped for a couple of minutes and then the pain almost fully went away, its back now about 72 hours later. Do you reckon i should stop playing football? And how long until full recovery?
Thanks
Hi Morgan, Sounds like a mild quad strain. I would follow the recommendations in the article and not return to sport until you can run full speed, accelerate and decelerate at full speed without pain. In mild cases that maybe 2-4 weeks. Though age, degree of injury and fitness level may affect those time frames. Hope that helps. Ben
I had pulled my quadricep muscle one week ago and it has healed good and I have regained all range of motion. I assume it was a low grade strain but I noticed when pulling it I had some mild spasms. One week later I feel good but now when I workout I feel almost like a muscle spasm in the lower quadricep muscle above my knee. Any idea what this is?
Hi John, Most likely the muscle is not completely healed. I would continue to work on range of motion, mobility/myofascial work of the quad and strengthening. This will insure a complete recovery. If it is still spasming you are likely at an elevated re-injury risk.
Ben
Hi Ben, I have been to see a physio and he reckons I have a mild grade 2 quad strain, when he was massaging my quad and going quite deep/hard I felt a pain no more than a 5/10 in the centre of my quad about 1.5 inches long. I have had the injury for 5-6 weeks. I also get a mild pain at the end range of motion when performing quad stretches and get aches when standing around for a long time and also when performing low level stationary biking that my physio wants me to do.
Hi Ben, I have been to see a physio and he reckons I have a mild grade 2 quad strain, when he was massaging my quad and going quite deep/hard I felt a pain no more than a 5/10 in the centre of my quad about 1.5 inches long. I have had the injury for 5-6 weeks. I also get a mild pain at the end range of motion when performing quad stretches and get aches when standing around for a long time and also when performing low level stationary biking that my physio wants me to do.
Hi Joe, The goal for rehab needs to be to restore full range of motion and strength. Initially the bike is good to promote bloodflow and circulation and possibly range of motion. However, you will need to progress into strengthening exercises. Slow and steady with an exercise/strengthening protocol is always advisable. You may ask your physio to line out a game plan for the next several weeks so you have an idea of their progression for you.
Thanks Ben, I have been given some strength/rehab exercises that I’m following, I was just wondering that if I’m getting mild pain with a deep tissue massage its obviously not healed fully yet?
Hi Joe, Honestly in my option massage in the location described is often painful….injury or not. So pain with massage is not an indication of injury for me. Your other symptoms of pain with end range stretching and pain when standing or using a stationary bike are better indicators of an ongoing injury. I would use those indicators to judge progress. You can always massage hard enough to cause pain so that typically is not a reliable indicator. Hope that helps! Ben
Hello Ben, I have injured my quad a good 5 weeks ago whilst playing sport , my quad was too sore for me to continue to play. It was initially sore to touch for about a week then the sourness gradually subsided, so I started to follow quad strengthening exercises from this website. Currently when I stretch my quad to see if there is still any pain there is only pain at the end range of motion, also I get quite bad aching of my quad (not pain like when I stretch) after going out for walks and after performing my strengthening exercises. What advice would you give me ?
HI Sarah…I can only offer general advice, but it sounds like you are healing but not fully healed yet. If you are getting pain with end range motion and walking then you need to continue to work on regaining full pain free range of motion and continue with the strengthening exercises before a slow return to sport. Be very cautious with your initial return as full speed running, cutting and stopping can lead to re-injury if you are not ready for those activities. For a bad strain 6-8 weeks is a typical recovery time frame. For some it can be 3 months or more. Let symptoms guide the progress. Hope that helps!
Hi Ben, had a grade 2 quad strain for about 6 weeks now. Everytime I try to build up to faster pace running, I get a pain in my quad and afterwards I get a small jelly like lump that appears, also my injured quad appears to be firmer.
Thanks
Hi Ryan…..Doesn’t sound like it is fully healed yet. I would back down the full speed work and continue to work on strength and full range of motion. I would suggest another 2 weeks then re-assess….if it persists then 2 more weeks. Hope that helps!
Thanks Ben for the reply, I was just wondering what causes a jelly like lump after exercise to my quad. I have been to see a physio and he reckons it’s very tight and when he massaged my quad 2 to 3 days after there was a lot of aching in that area, also I dont want to stretch the area to try and loosen it as I get pain at the mid to end range of motion.
Thanks
Hi Ryan….great question…can’t say for sure without evaluating you myself. But it sounds like you still have torn fibers and when you run it it causing swelling. This can often be felt as soft squishy or jelly like within the muscle belly. And yes even cause a lump. If this is still occurring we can make the inference that the new muscle fibers are being re-injured and causing the swelling and lump. It doesn’t sound like you are ready for that intense of activity yet. If you taper back the activity you are likely to heal faster. Keep it strong and mobile without causing re-injury. Hope that helps. Ben
Thanks for the response, now I have had this bump/lumpy area in the centre of my quad, that feels like a muscle knot for 2 weeks now without any signs of it reducing in size. Could I have myositis ossificans and how would I know?
Thanks
Hi Ryan, Yes Myositis Ossificans is a possibility with an injury in this location. It would need to be diagnosed my your medical provider. Typically via x-ray or diagnostic ultrasound. If you have this in most cases it will dissipate over time on its own. With a quad strain or MO you need to be sure not to re-aggravate the painful area. Unfortunately, recovery can be on the slow side. It sounds like you may want to follow up with your provider to discuss your symptoms. Best of luck and keep us posted!
Hi Ben, been to see my physio today and he reckons the bump/lumpy area is super tight so he gave me a massage in the area. I guess by him feeling around he doesnt think I might have myositis ossificans or he wouldn’t have massaged me, also he didnt suggest I might have it either.
Well….take it slow and easy as you rehab back to full time sport. You may have just tried to return to full speed too quickly! Take care and get well soon!
Hello, I have been suffering with a quad strain for 2-3 months, I have a lumpy area in the centre of my quad. I have been running when I shouldn’t have which has flared my quad up and caused pain. I have been researching and myositis ossificans has came up, I was wondering how common is myositis ossificans and what are the symptoms and anything you could tell me about it. Is a quad strain different to myositis ossificans, for example when I flex my quad back to try and touch my bum I get get a small pain at the end range of motion, I also get pain when I perform glute bridges when my hips are at the highest point. Biking at the gym has given me no pain. Any advice would be appreciated.
Thanks
Hi Graeme, Myositis Ossificans can form after an injury and does tend to form in larger muscles after injury. Basically a hematoma forms and then the area calcifies. This calcification is typically not dangerous but it can be very painful and take quite a long time to recover from. It is easiest to diagnosis from an x-ray or diagnostic ultrasound. If you suspect this it would be best to have it diagnosed from your medical provider. If running continues to cause pain then I would stick to exercises like biking that do not cause pain. Slowly work on the strength of the quad muscle and restoring full pain free range of motion. I would not massage the painful area aggressively if at all. But gentle tissue work around the other areas of the quad often works well and should not cause pain. Hope that helps!
Thanks for the response, my lumpy area occurred when my quad was still strained, so if myositis ossificans happens after a quad injury it’s likely I dont have it?
Well….not exactly. It does happen after an injury which means it can form as you are healing from an injury. Timing on when it might develop can vary wildly. So based on the limited information you have provided I would say you cannot rule myositis ossificans out as a possible diagnosis. I hope that makes sense…..but basically yes….you may still have it based off the description provided and the timing of formation.
Thanks, one final question I have currently been following these exercises from the website. I have also been doing some weightlifting, exercises like Romanian deadlifts which have been giving me no pain, so I guess I can continue with these exercises.
Yes….Correct…..try to avoid pain but progress the strength and range of motion. I wouldn’t go back to running especially full speed until you had full leg range of motion no pain and your strength was near normal.
Hi Ben, I will be assessing my leg every 2 weeks, I am currently training my upperbody, core and legs which have been causing me no pain. Aerobic wise I am stationary biking which feels fine. I will be looking to add the trap bar deadlift in my gym plan which is a key exercise for my sport. I know there is more load in my quads for this exercise, but if there is no pain I guess I can use this exercise? also would progressing my biking to elliptical training be a good idea?
Thanks
Hi Graeme, as long as there is no pain or swelling you should be good to go. Progress the deadlifts slowly at first. Yes…the elliptical is a great progression from the stationary bike. Like I noted before pain should be your guide. Sounds like you are right on track. Best of Luck!
Hi Ben, I teared my quad muscle 5weeks ago it was a type 2 tear I started with training week 6 and I did rehab everything went well the pain was gone and I could run without feeling any pain. But I’m back in the peach full training and yesterday I felt a sharp pain but when I run or kick I don’t feel anything I just feel it when I’m done.
Hi Vivo…sounds like you are not fully recovered. I would suggest slowing down the recovery a couple of weeks then taper back up. During this phase it can be easy to re-injure. Keep working on range of motion and strength training.
Thank you very much.
Hi Ben, i had a quad strain about 3 weeks ago then i rested for three weeks and when i felt no pain i started practicing football again, but then in a matchlike situation i hit the ball with my left and hurt myself again.
Then i seen a physio , he done some needling treatment and he loosened my quads , today after a week of that treatment and complete rest, i can feel no pain there but there is a stiffness only when i stretch my quads, i have started doing a little strength training too, but the only thing is – i can feel a sound of click or like that when i touch that inner quad spot, and it is only felt by a specific touch but no pain, what is that? And tell me when do u think i should start football training again?
Hi Ben, I had a quad injury that initially started as a grade 2 strain in late July/August I then continued to train when I shouldn’t have which made it worse. I then got some imaging done recently that shows I have myositis ossificans in my right quad and has been present since october. My sport/competition starts end of april/ early May, so would I likely be fit for then ? also what should my plan of action be?
Thanks Reegan
Hi Reegan, I cannot specifically address this question as I have not evaluated you myself or seen your medical records. 4-5 months is often enough time to recover but there are variables including severity of the injury, size of the bone that has formed, age, health status etc…I would advice speaking to your sports medicine professional and possibly getting a PT evaluation to help line out a program for you to get back on track and ready to compete in May. At first many of the suggestions in this article are applicable. But you will need to progress into a full training program including a training program designed to return to sport once medically cleared to do so. I hope that helps. I wish you all the best.
Ben
Hi Ben.
In 2016 I pulled my lower back badly whilst doing weights (forward lunges). Since then I’ve had a very stiff feeling lower back and feel as though I’m now more prone to back injuries. Around the same time I also pulled my neck and this area also constantly feels stiff and more prone to injury. This is why I’m now super strict on form whilst weight training and have also taken up yoga (last 2 years). I’ve always stretched and more recently I’ve started using a foam roller.
Recently I pulled a muscle in my quads as I was walking down the stairs (about half way up along length and in the mid to outer area). My leg wasn’t feeling tight and nor did I slip or step down awkwardly so I’m a little worried how easily it was injured. After a day or 2 I didn’t notice any pain or weakness until leg day at the gym: There was a noticeable weakness in the injured leg (still no pain) and also some shaking whilst under load. Leg felt fine for several hours after until stepping out of the shower and felt a sharp cramping type pain in that quad area.
Since then the injury has been more noticeable and I’ve been resting and then slowly rehabilitating it as per your recommendations. Any thoughts on the severity of my injury and why it wasn’t until several hours after weight training (and a week after initial injury on the stairs) that it suddenly cramped and I felt a sharp pain? Also, do you think my ongoing lower back stiffness could be related to how easily my quad injured on the stairs?
Hi Daniel….sorry to hear about your injury. Of course I am only speculating given I have not evaluated you for my self. But for mild strains and sprains it is not uncommon to have a delay of pain or swelling. It takes several hours for the inflammatory markers in the body to build up and sensitize the area and cause pain. In severe injuries this happens very quickly. Most likely you had a very mild strain but when you placed it under load it worsened the injury. Low back pain can definitely increase the risk of injury in the lower extremities. There are many theories as to why. It could be there are issues in the low back sending inappropriate signals to the nerves in the legs causing weakness or tightness predisposing one to injury. Also tightness in the low back can change movement patterns and the length tension relationship in the leg muscles again potentially pre-disposing them to injury. Given your history…..recovery should be focused on the injury site directedly as well as the low back/core. The Resilient Runner Program on the MTA sight has more insight for the quad strain and back pain. For a deep dive on low back pain and better was to improve core and lumbar strength here is a link to my book https://www.thephysicaltherapyadvisor.com/2017/11/29/whats-inside-of-the-treating-low-back-pain-during-exercise-and-athletics-video-package/
Hope this information helps…..best of luck! Ben
Thanks Ben, appreciate your advice.
You’re welcome, take care!
hi Ben,
My radiologist report came back and said I have a grade 2 strain of the vastus medialis and a grade 1 strain in the vastus lateralis muscle. Walking does cause a lot of pain and feels like its catching. Should I keep off of it completely are should I try just suck it up and walk on it. Or should I just walk short distances and use crutches for going out. And at what point should I start walking if I need to keep off it now? Also I play basketball, how long do you think recovery time will be before I can play again ?(everything I read said 6+ weeks).
When the injury took place there was also very severe swelling and the swelling is still here not near as bad but it has been here since last Friday
Sorry last question, is a grade 2 strain a partial tear or no tear at all?
Hi Katelyn…A grade 2 strain is a partial tear and will require longer to heal. You can walk without crutches assuming the pain is only mild, otherwise I would use the crutches. Basketball is likely out for up to 3 months depending on how fast you heal and your symptoms. You may consider the MTA Resilient Runner program. There is a great write up on how to self treat a quad strain. Including how to progress and when to progress. Other get some advice from a sports medicine provider. Best of luck!
Thank you so much!!
Hi Ben, I have had quad pain/discomfort for 8 months after my initial injury. I Only get pain when stretching end range of motion, for example when lying on my front and pulling my heel towards my bum and also faster paces of running. when I seen my physio, he says my initial injury has fully healed and I agree as it has been 8 months. He thinks the lumpy/firm area in the centre of my quad is scar tissue and is pulling when I try to run quickly also there is tightness of that quad muscle. He has given me some dynamic flexibility work, strength work and also shockwave therapy. I mentioned myositis ossificans and he gave me reasons and ruled it out and said there is no need for imaging, so what exactly is going to change to stop my leg from getting pain at the end ranges of motion/fast pace running?. He gave gave me a lot of information, so cant remember everything, but he did say that lumpy area might always be there.
Hi Marion….It is true after a severe muscle injury you can develop scar tissue that will remain “lumpy” feeling. It sounds like your physio has given you some solid advice. I would continue with the strengthening and dynamic stretching. Typically working eccentric exercises where the muscle is getting longer while you load it is a good way to help recover. Also I would be doing a lot of manual work while doing the stretching and strengthening. You can do foam roller exercises, mobility band work or instrument assisted mobilization using tools to help. The MTA resilient runner program has a great write up with exercises and self mobilization to help recover from a quad strain. Best of luck!
Hi Ben, thanks for the response when performing the stretching exercises I get some pain at the end range of motion as stated before. Should I go to a point where there is no pain stretching?
Thanks
Hi Marlon…I typically advise clients to go to a mild or moderate stretching sensation but no pain. Ben
Hi Ben, this article is a tremendous resource. Thank you so much!
I injured my left quad 14 weeks ago while(I suspect) doing squats at home (a) insufficently warmed up and (b) too heavy a weight too soon. Since then, I have not done any weightlifting and have stopped much aerobic exercise (dance work-out videos at home due to COVID).
While the initial acute pain has faded, I continue to get soreness/tightness in my quad whenever I do anything particularly active with my legs: squatting down to clean the bathroom, long walks (pain later on or the next day), or stretching my legs (gently stretching the quad).
Any sense on why the recovery is taking so long? Thank you so much again for this article.
Sorry–just to clarify:
– I assumed the injury was grade I, because I didn’t feel any pain at the time of the suspected injury. I only felt pain the next day. And when the pain started, I was able to keep walking despite the discomfort. The initial pain was a soreness in the front quad, which also went away after two weeks (but it does return any time I did much with my legs).
– Also, over the last 14.5 weeks, my exercise has been completely curtailed. I’m doing no weightlifting and no aerobic exercise besides occasional walks. (I’ve stopped my silly-but-fun COVID-era dance workouts at home.)
Hi Jeremy….14 weeks is a long time to keep having re-occurring symptoms even with gentle stretching. It could be there is more to the injury than you initially thought. You might consider getting imaging to help better guide the rehab. The other route to try is a very slow but progressive range of motion and strengthening program. If you can slowly taper up the activity and the pain remains the same (not worsening) then you just continue with the linear progression. Hope that helps.
Thanks, Ben! Great advice.
Hi Ben,
Three days into my high school soccer season I randomly got this pain in my right quad muscle during practice. I thought it might just be a cramp from dehydration so I drank water and kept playing. Later in practice I tried to sprint and it pulled within seconds. That day the pain lingered but the next morning when I woke up it was more or less gone. I went back to practice and everything was fine until I accelerated after a move and it seemed to pull again. The pain stuck around and I sat out of practice icing my leg. I’ve sat out for the past 3 days but I want to return to practice as soon as possible. What should I do in regards to warming up etc. in order to prevent my leg from straining again?
Hi Rosie….you are correct…warm up will be the key…I advise a dynamic warm up consisting of foam rolling and then active movements such as squats, lunges and slow jogging progressing into more dynamic movements such as butt kickers. Keep the area warm. You may also consider some compression garments or an ACE wrap to help keep the area warm and additional support. Hope that helps.
Hi Ben, I have myositis ossificans in my quad muscle and it has been present for some time. A specialist has said you normally rest for 3 months and then start a steady rehab plan. I have been working on lowerbody strength work with various different exercises which have been ok, apart from split I feel a slight twinge/discomfort. Also when I went out for a jog running very slowly for around 5 minutes the next day I woke up being quite stiff, finding the leg quite hard to flex. Since I have had the injury for around 6 months surely there cant be any anymore more bone formation by a slight flare up. When I stretch my quad there is a different sensation in the injured leg at the end range of motion, also does the lumpy area have to disappear completely and what exactly causes the pain with MO that is different to a regular strain. My competition for my sports starts in May and I would like to be fit for it.
Thanks
Hi Mark…tough questions. The lumpy area does not have to fully resolve to start back to training and it may or may not be the cause of the pain. The bone formation causes the muscle tissues to contract differently whether you are stretching or exercising. So the cause of the pain can be from that or the bone or other compensations. I can’t give specific advise since I haven’t evaluated you. But it maybe that you try to continue with your rehab routine and slowly, very slowly taper up the running and see if your leg can accommodate for the slow training stimulus. Keep working on rehab, range of motion and strength, and just continue the slow taper and see if it can get past it. IF the pain continues to worsen then you will have to back it down. I hope that helps.
Ben
Thanks for the response. What are the best ways to work on range of motion?
Thanks again
Hi Mark,
There are lots of ways to improve range of motion. The easiest is bicycling. You can stretch and utilize a foam roller to assist as well as long as you don’t role over the OA. For a complete recovery program I wrote a 50 page .pdf file about how to self-treat a quad strain along with a rehabilitation guide in the Resilient Runner program. You can read more about it here:
https://marathontrainingacademy.clickfunnels.com/injury
Hi Ben, I have been working on my leg strength and started running last week( 1min jog, 1 min run ×5) so a total of 10 mins and increasing this gradually. I did not get any pain running but I noticed over the course of the week my thigh/quad has gotten bigger, yet again no tenderness to the area like i would get 5 months previously just slight swelling I think and slightly firmer. I guess since i have no pain I can continue?
Thanks
HI Mark…I would not continue on the taper….Just stay put on the volume. Also….Try to be scientific about any changes in size. Pick 2-3 land marks on the thigh like 2 inches up from the patella and then do circumferential measurements. Keep track of these to know for sure if the leg is swelling. Ben
Hi Ben. Your article is such a great find. Thank you! I have a question however. My 19 year yr old son is playing college club soccer, and strained his quad in a game 2 weeks ago. He pulled himself off the field after he felt a strong pain after a sprint. He’s been going to the college PT since the injury happened. Lots of ice and compression week one. Seemed as if it would heal quickly. Had full range of movement after one week, and was practicing gently. Jogging, dribbling, etc. After about 9 days, tried striking the ball (not hard) but there was pain. Injury site became very achy and sore to the touch. He is now resting with no activity. It’s been 16 days now. Still painful to the touch, and loss of movement. Cannot do PT exercises without pain (flamingo had no pain week 1 but pain now). Why is it so tender to the touch? Is this normal to get worse before it gets better? Just not sure if he made it worse or if this normal for healing. Any thoughts would be appreciated!!
Hi Laura…based off your information it sounds like he re-strained it. When this happens the time table for healing can basically start over. He may have even strained it worse the second time which isn’t uncommon. He needs to start over with the ice and compression and regaining full motion. Then work on some strengthening. Avoid anything that requires a quick or unexpected movement. It could be 6-8 weeks depending on severity. Hope that helps. Best of luck.
Hi Ben, Hoping you can advise. I’m a triathlete with many years of running beforehand. After an excellent year of high volume polarised training through the Pandemic, I was 60mins into a 90min recovery run the day after a 4hr cycle when I experienced a sharp pain directly above my right patella. The pain subsided after moments and I was able to finish the run and continue to train. However, over the following week other knee issues began to surface including classic ITB tightness issues and general discomfort around the patella. This seems to fit well with the symptoms you describe. However, this was last November. I rested for a month, resorting only to swimming. However, symptoms intensified. Come February I engaged a physio whom has prescribed numerous VMO strengthening exercises alongside numerous exercises to place stress on the tendon in order to trigger rebuilding. This has enabled a return to running, although some niggles around the patella persist. However, cycling is an ongoing problem. Even the lightest of flat, easy efforts in the range of 10-20mins causes a considerable reaction – soreness, burning sensations and a general intensification of symptoms. The tendon itself is ‘lumpy’ when rubbed with a thumb in comparison to the same area on the left knee. There is no bruising, redness or heat. There are numerous tender spots higher up the quad but foam rolling again aggrevates, even if I restrict attention to much higher up the quad. I know that was a lot of rather superficial information. Any suggestions or advice for rehab techniques would be welcome.
Hi Mark, This sounds a lot like Patellar Femoral Pain Syndrome. This is typically caused by poor patellar tracking. VMO weakness can be associated with this but I find that hip weakness is a bigger issue. Particularly the deep hip external rotators. The lumpiness in the tendon is likely from over use within the quad tendon. Check out this post…. https://www.marathontrainingacademy.com/how-to-self-treat-runners-knee
And this product….
https://nuneeshop.com/pages/about
Hope that helps!
Hi, I have a sharp throbbing pain at top left of my thigh (if I were to put my hand in my pocket, it would be to the left of my fingers). This is accompanied by a very tender area a few inches further up towards my hip. I cannot remember hurting my leg, although I have a vague recollection of over stretching and twisting my leg while sitting in my car. From a mild throb, the pain escalated quickly over a couple of days – two weeks later and the pain is still the same and with no sign of recovery. Please help. Many thanks.
Hi Simon, Pain in this area could be trochanteric bursitis, tendonitis or could even be related to low back pain. First goal to recovery is identify which movements cause the pain to worsen, and do less of those movements. Then find movements that make it feel better and do more of those. Icing intermittently in this area is often helpful for pain. Hope that helps!
Hi Ben, great article. Last weekend I was playing kickball and as soon as I extended my leg to kick the ball it felt like a rubber band popped in my quad. I’ve been resting and icing for 4 days and I’m starting be able to walk without a limp anymore. I have a wedding I’m going to in a couple days and I’m worried all of the standing/walking might re-aggravate the quad. Should I wrap it or wear a compression sleeve to help protect it? Thanks
Hi Trent….It definitely won’t hurt it to wrap it or use a compression sleeve. Try them out before the wedding and see which one is more comfortable and seems to help the most. Don’t let the wedding day be the first time you try it. Would hate for it to backfire on you. Good Luck!
Hi Ben – It seems from your previous comments that a quad strain usually stems from a specific event. I didn’t experience an incident where I felt immediate pain, popping, or snap. On the day I first felt the pain, I ran a small 4 mile run, dug some fence posts, and mowed some grass. Later in the day I went to stand up from a chair, and I felt a sharp pain in my inner thigh (slightly higher than middle of the thigh). Every time I took a step, I felt the same pain generally in the same location. I continued the next 2 days doing regular yard work while experiencing the pain. Third and fourth day I took it easy but still experienced the pain while walking. Fifth and sixth day I decided to walk around with crutches but if I didn’t use the crutches I felt the pain. Today, the seventh day, it feels much better but I am afraid to walk around on it as I am afraid it might start to hurt. It does not hurt while walking up and down stairs – just while walking normal. Small background – I have recently had hip labrum surgery with cam impingements and dysplasia surgery on both hips (Right side done July 2020, Left -which is the thigh that hurts- October 2020). I am slowly coming back to sport but have been cleared to do normal things like yard work. I know it is difficult to provide advice without an evaluation but I was curious to see if you felt if I had a quad strain without incident or if it could be something else – and your advice as to how you think I should proceed. Thanks for your help.
Hi Nicole….thank you for the excellent description. I cannot give specific medical advice but I do have a few thoughts based on your description. The details you provide do not line up with a quad strain. For example going up/down stairs is not causing you any pain. This would be the opposite in a true quad strain situation. As stair climbing would cause a lot more strain on the quad vs normal walking. Your events leading up to the pain list out a lot of activities. These activities cumulatively sound like a high volume of work that makes me wonder if something was inflamed or irritated. Given your history of hip issues and knowing the hip can refer pain down the leg I would think the first area that would need to be screened would be the hip. If the pain is not resolving with some rest after a week you should follow up with your physician. All the best! Ben
Hi Ben – Thanks for such a quick reply. My first thought was my hip but couldn’t help think maybe quad this time???. I emailed my doctor after reading your reply. I appreciate your help!
Hello Ben,
I have recently started playing soccer again. I am fine running and sprinting. However as soon as I shoot I get a sharp pain in my middle/upper area of thigh/quad, which hurts for the rest of the game. It’s like a quad has pulled or strained. The next day my leg is fine and I can walk. After a week the pain is completely gone. But as soon as i start playing again my running and sprinting is fine again but after taking 1 shot the same thing happens to my middle/upper area of thigh/quad.
Is this just a strain or has my thigh/quad muscle torn and is not fully healing? What should i do to ensure it is fully healed and doesn’t happen again?
Please advise and thank you for your help.
Great question! I can only speculate since I have not evaluated you but it is likely there is still a small partial tear that is aggravated when put under stretch then asked to produce a high amount of power when shooting. In these cases I usually work with my clients on a strengthening routine with a heavy focus of eccentric work. This would include barbell training and particularly squatting but also any exercises that can emphasize eccentric loading. Hope that helps!
Hi Ben,
I have recently started playing a soccer game, last month Jun 8th without the warm-up i started to play then with the first kick I got pain above the right knee near the quad. I got the doctor’s appointment for August, i have one more month of time to visit a doctor. i have difficulty walking, I can walk very slowly, I can’t do workouts also. feeling scared that how long it will take to completely recovery,
any medicine or home remedies do you suggest before meeting the doctor?
any upper body workout shall I do at home just to be active without hurting the knee or quad?
Hi Anitha, Sorry about the injury. Any upper body work outs you want to do that don’t cause leg pain would be fine. Be creative. Whatever you like. As far as the injury goes…its difficult to give advice without examining you. It could be the quad or even the patella/knee cap. A good rule of thumb is to work on pain free range of motion with the knee. And once that is restored, starting working on regaining strength. Initially with things like leg raises as long as there is little to know pain. I’m sorry I cannot be more specific than that without a more clear picture of the actual injury.
Ben
How can I bandage a pulled quad
HI Gavin….There are many ways to do this. You can use a simple ACE wrap and apply a spiral technique and wrap it up for direct compression or even use compression tights or shorts. There are also many kinesiological type taping techniques. If you want some advanced rehabilitation protocols and demonstrations of taping techniques I would suggest Checking out the Resilient Runner Program. https://marathontrainingacademy.clickfunnels.com/injury1
There is a ton of information there to help you self rehab a quad strain. I hope that helps!
Hi Ben,
I was at soccer practice around 2-3 weeks ago (July 5th), when my quad started aching and feeling a bit tight. I kept playing after that because I had a soccer tournament but then it also started hurting whenever I kicked the ball. I took around a week off after that and did nothing besides icing it. I went to the doctor and she thinks that I might have a quad strain. I had a soccer game yesterday though (July 23rd) and was contemplating whether to go so I went on a walk/jog and it wasn’t hurting, but then when I was warming up for my soccer game and doing long balls, my quad started hurting again. I played through the game though, but I have another game today (July 24th) and tomorrow (July 25th.) Should I still play during those two games? I really want to play but is it okay for me to? I don’t want to have to take time off to recover again because I have tryouts (August 26th) but I also want that pain to go away. Right now the quad sort of is tender, sore and a bit achy when doing nothing and then when kick the ball hard, there is a bit of a sharp pain in my quad. What should I do? And how can I make my recovery extremely quick? FYI, it’s only my right quad that is hurting, my left is fine. Thanks!
Hi Millie…I can’t really answer your questions without a complete evaluation. Only you can decide how severe the injury is and if you want to risk further injury. The article outlines techniques to self recover. But the key will be figuring out why the pain started in the first place. Focus on that between now and Aug 26 and your likely to be better off then just treating the pain only. Ben.
Hello doc, I run skeleton so that invloves highly short distance sprint. and recently their has a been a minor pain in my upper quad but more painful after each practice but the next day not really sore and after my warmup ceases to exist until after a couple of sprints? Could this be a tear in my quad or is it just soreness from overuse?
Hi Jarett…Typically with a tear there is a mechanism of injury. An incident that results in the tear. Most likely you are experiencing an overuse tendonitis of some kind.
Ben
Hi Ben! First, thanks for this article and for your continued engagement with everyone’s questions and comments. Very informative and much appreciated!
I am 47 and a regular runner (up to 10k… no marathons, yet!) and I play hockey. I fell down some stairs several weeks back and partially tore my right quad tendon, which was confirmed by an MRI. I have progressed through PT and I can walk, go up/down stairs, and perform most daily activities with no pain at all. I would describe the current sensation as tightness in area of the tear when I place heavier loads on it.
My question is… now that I am pain free, I would like to get back to walking longer distances and light jogging. Do you have any advice on post-therapy, progressive, walk/run programs for this type of injury? My current plan is to simply take it slow, listen to my body, and resume normal activities once I feel like I have regained the strength in my quad without tightness.
Any other thoughts are appreciated. Thank you again!
James
Hi James,
The initial goal is to always regain pain free full range of motion while you progress strength. You can start back to walking and jogging as long as it doesn’t aggravate the injury. Here are a few important points to consider are to have an extra long warm up and cool down period. Do continue with a strengthening program during your return to running. I would advise a very slow taper up and that usually starts with a jog/walk program. Such as walk 2 min and jog 1 min and progress from there.
Hope that helps! Best of luck!
Perfect, Ben. Thank you again!
Hi Ben,
I’m hoping to get your opinion about my quad injury, which I know is difficult without examining me.
In mid August I strained my left medial quad while sprinting, rested it for several weeks, and then participated in some planned activities (1 day basketball tournament, 3 day hiking trip). It felt OK during those activities but not 100%. By mid September it was still sore so I began physical therapy. The initial work was focused on lengthening the muscle while the strain healed. My PT did manual therapy and we did some light exercises on both legs. I also had a massage to work out an adhesion in the lateral quad that was causing discomfort.
According to my PT my muscles feel quite normal now, and we began some single leg eccentric work 3 days ago (side step downs, single leg bridges, and standing calf raises). After PT I did a light 45 minute bike ride on my trainer. For the last 2 days my quad is very sore, and almost feels like I’ve re-injured it. It hasn’t felt this bad since the initial injury. I suppose it could be severe DOMS, but even going down the stairs is borderline painful.
Do you have any recommendations or does this sound typical? I’m starting to become depressed that it hasn’t improved quickly.
Thank you for your time.
Hi Thomas,
Sorry to hear about the injury. Significant strains can definitely take a while to heal so don’t get too discouraged. The most common problem that comes up during rehab is pushing things too hard too soon. While I agree that eccentric strengthening is critical to a full rehab starting with this first can cause more pain as it is much more difficult for muscles to work eccentric vs concentric. So I would not start my strengthening program out with eccentric only exercises. I would do a combo of both and eventually emphasize the eccentric. This could decrease the soreness. You sound like you may have just overdone the exercises. I would go back to some TLC for the quad and back down the exercise some. Keep going though. You need to work on strength training in general including squats and deadlifts. No just eccentric isolation exercises. Taper up very very slowly to insure no set backs.
Hang in there…you will definitely recover from this.
Ben
Thank you Ben. I appreciate your help. Finding the sweet spot between properly stressing the muscles and not overdoing it is difficult.
Hi, i noticed you actually taking the time to give thoughtful responses so thought I’d ask my question – I’ve been speed walking on an incline on my treadmill everyday – one day a few weeks ago started feeling a pain in my left upper thigh closer to the hip side. It is stubbornly not healing despite being on prednisone (for a diff condition) and Meloxicam. I’ve rested intermittently. What can help? Can i speed walk on flat ground instead? Would an orthopedist consider giving a steroid injection? Thanks!
Hi Jen,
Great question. I’m not exactly sure of the location you are noting, but it could be hip flexor or a form of IT Band syndrome. Typically the diagnosis doesn’t matter too much in cases like yours. Its likely an overuse injury resulting from muscle imbalance else where. The most common issues are either a shoe issue causing an altered gait pattern from your normal or muscle weakness in the deep hip rotators causing other muscles to have to overwork while maintaining good lower extremity alignment. My suggestion would be to check your shoes and see how worn they are….most shoes only last 300-450 miles. And start a hip strengthening routine. You can find everything you need to know along with pictures and step by step guides through our Resilient Runner program (https://marathontrainingacademy.clickfunnels.com/injury1). In the mean time I would try altering your pace and/or elevation to help manage the pain better. Best of luck!!!
Hey Ben
I was playing Soccer and kicked another player while attempting a shot. I was able to keep playing for a few minutes then my knee had intense pain and I had to stop. Pain subsides after a few minutes and I can play again for a few minutes and the pain comes back almost like it locks up. I played the next week and was fine the first half then the pain came back. I took 3 weeks off, no pain during this time, but when i returned to soccer it was the same scenario. Could this be a pulled quad or tightening of the quad or calf during game. It seems to be when I kick. Thanks in advance.
Hi Charlie….thanks for the question. Based off of that information, it is hard for me to know the answer to your question. It sounds as though it is the knee that is hurting, not the quad/muscle. If that is the case, then there is a reasonable chance you have injured the knee. You may have a ligament sprain or small meniscus injury. If the pain persists, I would suggest an examination to determine the cause of the pain so you can develop an appropriate treatment plan. All the best!
Ben
Hi Ben,
I’m back asking for more advice almost 3 months later!
I’ve been slowly increasing my exercise regiment to include deadlifts, squats, etc. My legs will be sore for 1-2 days after heavy lifting but then it recedes. The PT I had been seeing cleared me to start a return to running program at the end of January. I did 1 minute jog / 5 minutes walk, 2 minutes jog / 4 minutes run, etc. Yesterday I was doing 8 minutes of jogging and 1 minute of walking, but about 2 minutes into the 3rd (and final) set of jogging I started to have pain in my vastus medialis on foot strike. I stopped the run, walked home, and it’s been tender since – especially going up and down stairs. My gut tells me this is just another case of overdoing it, to take several days off activity, then resume weight training, and in another week or two resume the walk/jog program at a lower level. Perhaps starting this program from the beginning:
https://www.uoanj.com/wp-content/uploads/2015/02/Return-to-Running-Program-Steve-Cole-Wm-Mary.pdf
I wanted to ask your opinion here in case you had any other suggestions. Another thought I had was to get the quad evaluated by another doctor, but when I asked my PT he didn’t think it was necessary.
Thanks again for your generosity in replying here to myself and others.
Thomas
Hi Thomas. Thank you for the update. I agree with you based off the information provided. I would back down both the weight program and running program at least 25% and then start a slightly slower taper back up. It’s very easy to taper too fast. Hope that helps.
Hi Ben,
About a month ago I pulled my quad muscle skateboarding by hyper extending it.
I took 2 weeks off from activity.
I also play soccer.
I have been feeling pain when I shoot the ball in my thigh. I dont feel pain doing anything else in soccer- but pretty bad when I shoot.
Is it okay to play soccer and not shoot- or do I need to let it rest completely for a few more weeks?
Thankyou
Hello Ben,
Fantastic article. I have been searching for just this information for days now, and luckily I found your website. I just wanted to thank you for posting this.
Also, I thought I might ask a question, and perhaps the answer will answer others who have a similar question, if not the same question.
I recently decided to get back into football (soccer football that is), and was practicing free kicks. It has been probably about 10 years since I played; however, I have been active throughout those 10 years, working out six days a week, from weights to plymometrics. Anyway, I have strained my quadricep, specifically the rectus femoris. It is a Type 1 (borderline Type 2).
It had been a week, and I was able to do plyometric training just the other day. I assumed it had healed and wasn’t that bad, so I attempted to take a free kick today, and it hurt worse than the initial injury. It took just one kick to cause my leg to hurt badly. The pain has calmed down in the last couple hours but has obviously been reinjured worse than before.
My question to you is why would someone who, despite not kicking a ball for a good amount of years, would experience this kind of injury despite being very fit and able to squats, lunges, plyometrics, etc. just the other day? I don’t quite understand how an injury like this could occur unless I had been inactive and not stretching.
I will say that I never use a foam roller or a thera-band roller because it’s painful and I have been able to get by without using one.
Anyway, why do you think someone who’s fit and active would suffer a strained rectus femoris after kicking a ball for half an hour?
All the very best!
Hi Ben,
I’m hoping for your thoughts on what I believe to be a rectus femoris problem.
A little background: I’m a 3 mile a day walker (prior to this incident), but otherwise have an eight hour a day sit down job. Due to Covid and my wife’s immunocompromised status, I’ve not been to the gym in three years, so my core and upper body strength is lacking. My posture while sitting is poor.
About six weeks ago I started having slight pain in upper rear hip region on the right side. I attributed this to a sagging mattress and fixed that problem. It didn’t resolve the pain. I next tried core muscle and hip flexor stretches. I quite possibly overdid these. Along the way I pulled out my own weights and started lifting what I felt were reasonable weights given my status. While bench pressing, I felt a slight give at the front of my right hip. Nothing audible, and nothing directly painful, but it didn’t feel ‘right’. I knew enough to stop there. From that point forward the pain was a little greater and there was some general discomfort. Regardless I continued my usual activities including my 3 mile walk. About five days later the pain while walking had increased to a five out of 10 and I stopped the walks.
At this point I was still fully functional, just not comfortable. I made an appointment to see a chiropractor my wife have a lot of respect for. He also dues soft tissue work so we felt he was the right resource. Between the first and second visits there was some improvement (a couple of two mile walks with minimal discomfort). The quad stretching during the 3rd visit was very aggressive and painful. For the next day and a half I would say I was at a consistent 8 on the pain scale with much more limited mobility. The morning of the third day the muscle(s) in the front of my thigh went into spasm for about 5 minutes. The pain level was 10+. This was a week ago. Since then, I’ve been unable to walk more than fifty feet without major pain. I can start walking with pain at a 2 and 50 steps later I’m at a 9. The feeling is one of pain/pressure in my thigh. Sitting is equally difficult- even when I shift the load to the undamaged side of my body. The front of my thigh is painful from the tendons at my knee up through the muscle to the tendons at the hip. I rest in bed, and alternate between heat and ice. The pain has started to subside, but I.m out of the game. Unable to walk, shop, cook, etc.
Yesterday I visited a PT (referred to by Chiropractor) who specializes in sport injuries. I brought a pair of crutches and had a family member drive me. On the way over the front of my thigh went into full spasm again for about 15 minutes. The PT seems to believe that this combined with the history above doesn’t fit the normal pattern of injury/healing, and he and my chiropractor are suggesting an Ultrasound of the Femoral Triangle, and an x-ray of the area.
I’m all for the imaging, but from where I stand I can see a couple of points at which healing had started, and then was aborted. 1/ the very aggressive stretching during my 3rd chiro visit and 2/ the two spasm episodes that set me back.
There is no visible bruising, no palpable bumps.
Three more points of interest:
1/ left the PT’s office with a compression wrap around my thigh from knee to groin. This has definitely helped with the discomfort.
2/ When sitting (briefly) I can feel the top of my thigh ‘buzzing’ against the wrap. Seems a nerve is getting activated in some way.
3/ The Chiropractor evaluated for nerve impingement/involvement at the outset, and could find none.
What is your take on the above?
Thanks for your help
Hi, I recently have been dealing with many muscle injuries. the rest have healed but as i came back i was very sore in my quad and think i pulled it. what should i do? i play soccer. give me the full list and timeline please. i have a big tournament coming up in a week. thank you.