Quad Pain

Quadriceps injuries
The front of the thigh is the site of common sporting injuries such as ‘dead leg’ or quadriceps muscle contusion. This is usually caused by a direct blow to the muscle causing local damage resulting in bleeding into the tissues. Contusions can occur anywhere in the quadriceps muscle. Physiotherapy treatment can result in reduced pain, promoted healing and faster return to full activity.

Muscular strains of the quadriceps muscles are also relatively common. The site of pain is usually well localised in cases of muscle strain. Muscle strains occur in the mid belly of the muscle. A muscle strain usually occurs with an increase in running speed or extra distance kicking. A sudden pain is felt in the front of the thigh. There is local pain and tenderness and, with a severe strain, swelling and bruising occur.

If the pain is variable, not clearly localised and if certain aggravating factors are lacking, it may be referred pain. Referred pain may arise from the hip joint, the sacroiliac joint, the lumbar spine or nerve structures.

Treatment
Muscle strains and contusions are treated in much the same way. Management includes minimisation of bleeding and swelling. Treatment is aimed at the restoration of full range of movement and strength through massage therapy, electrotherapy, stretching and a progressive muscle strengthening programme with the result in return to all activities.

Hamstring Injuries
Hamstring muscle strains are common injuries among sprinters, hurdlers and long jumpers. They also occur in other sports involving sprinting.

Treatment
The effective management of pain in the hamstring area is dependent upon correct diagnosis. Initially the therapist must diagnose whether the injury to the posterior thigh is a muscle strain or pain referred from elsewhere so that appropriate treatment can be carried out. Over the first 48 hours regular ice and compression should be applied. Treatment is aimed at the restoration of full range of movement and strength through massage therapy, electrotherapy, stretching and a progressive muscle strengthening programme with the result in return to all activities.


Other Problems

Hamstring Tendinopathy
Tendinopathy of the hamstring muscle group may occur at the origin (back of the knee) or the insertion (buttock) of the hamstring muscle group. Both present with the typical inflammatory pattern of warming up with activity and an increase in pain post activity. Tenderness occurs over the tendon with associated thickening.

Ischial bursitis
Ischial bursitis presents with pain when sitting on hard surfaces. The two aforementioned conditions do not significantly limit the performance of a running athlete however, they can be quite annoying.

Ultimately these conditions require sufficient rest and rehabilitation.