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2-Step Pulled Quad Treatment Plan

by Jaydee Vykoukal, PT, DPT April 14, 2022 0 Comments

Woman using foam roller massage

A pulled quad, or quadriceps muscle tear, is a sports injury most common among active middle-aged individuals. A pulled quad can be anything from a minor annoyance to a complete life disruptor, depending on how severe the tear and symptoms are. Knowing the best pulled quad treatments at each stage of recovery will give you the best results. Keep reading to learn more.

2 Step Pulled Quad Treatment Plan

There are two primary healing phases following a tear of the quadriceps (most often of the rectus femoris muscle). Keeping these stages in mind can help you feel confident in the recovery process and allow the healing to progress along smoothly.

Step 1: Treat Initial Symptoms

When connective tissue within the quad muscle is damaged, the body launches its own cascade of cellular events to promote the healing process. The injured tissues send a signal that they need help healing. This causes the local vessels to dilate and fluid to leak into the space as healing cells come into the area to start the healing process; which attributes to the initial phase of pain and swelling within the first 3 days. Thus, keeping your leg comfortable immediately following a quad injury is imperative in the first 48 to 72 hours with the following modalities:

  • Cold Therapy

    Putting ice on a new injury is a common go-to treatment as part of the RICE protocol for an acute injury (rest, ice, compression, and elevation). This is because of the pain relief it can provide while helping keep your swelling manageable with constriction of local blood vessels. Place ice (an ice pack with a t-shirt or dish towel) on the affected area for 10 to 15 minutes until the area has become numb. It’s important to remove the ice after gaining these therapeutic effects to maximize your benefits from it.

  • Compression

    Adding compression to your cold therapy will advance your recovery efforts even further. Compressing the injured quad muscle, while using ice or continuously throughout the day, will prevent stagnation and excessive swelling by promoting better circulation. This ultimately leads to better healing potential and less pain. You can utilize options as simple as an ace bandage wrap or leg-sleeve to a full compression system.

    Guide to Proper Compression Therapy

  • Elevation

    The final component in the initial recovery stage that can be combined with compression and ice is elevation. Prop your leg up on a stool when sitting (or pillow when lying down) to get it above your heart and help excess fluid move toward your heart and away from the injured area. In fact, anytime you’re sitting or lying down for an extended period of time you should make an effort to keep your leg elevated in those crucial first 72 hours- and beyond if you’re still experiencing swelling.

  • Time Off

    When you aren’t treating your leg with the combination of options listed above every two to three hours, it’s important to let your injured tissues heal. This helps minimize strain on the injured area. For the first few days, that typically means reducing your activity level. If the injury is minor, you may just need to modify your activity level. However, if your injury is severe you may need crutches or a cane for a period of time to allow appropriate rest and prevent further injury. 

  • Anti Inflammatories

    If the treatment options listed above just aren’t getting you the pain and swelling relief you need, or you want an extra boost, you can talk to your doctor about the use of a nonsteroidal anti-inflammatory medication (NSAIDs). Over-the-counter medication like ibuprofen, Advil, or naproxen can give you short-term pain relief and keep your symptoms manageable. This keeps you comfortable as your tissues heal.

Step 2: Rehab Injured Quad

At some point after your initial recovery, it will be time to gradually get your leg ready for returning to your normal daily activities and sport. When this will depend on the severity of your injury. However, in general, the sooner you can start the better as long as you’ve been cleared by your doctor to start doing more with your leg. Below are a few important treatments that you will want to do to continue forward with your quad recovery.

  • Warm-Up Before Exercise

    Most importantly, you will want to prevent re-injury of the quads as you gradually return to your activities. Having a well-designed stretching and range of motion program that you can complete before (and probably after too) any other exercise or sport can help. Keeping your tissues warm and flexible will reduce strain on the quad and help you feel your best.

  • Perform Targeted Quad Exercises

    Your quad will need some appropriate rehabbing with specific strengthening exercises when it’s ready as well. This typically entails starting with very basic quad activation exercises of the front of the thigh and eventually progressing to sport-specific moves. Plus, you’ll want to make sure your surrounding leg muscles are also strong and can coordinate well to maximize your performance and help prevent any future issues.

    Exercises for Pulled Quad

  • Foam Rolling

    The use of a foam roller is a great way to administer self-massage to the quads and other soft tissue at home. Since the quads are composed of 4 big muscle groups, the large surface area that the foam roller can cover at once is ideal for this area. Slowly rolling up and down and stopping to focus on any specific sore muscle fibers, can promote blood flow, healing, and give you much-needed pain relief. For specific instructions on foam rolling the quads and other thigh muscles, look at our video here.

  • TENS Therapy

    If you are having trouble tolerating your daily activities and exercise, consider using a TENS home unit. Applying electrodes around your injured quad will result in a tingling feeling that can give you temporary pain relief. This holistic form of pain relief can help you better tolerate your exercise program and daily activities with less dependence on medication as well. Plus, electrical stimulation can be combined with other treatment options like ice and heat. 

  • Try Heat Therapy 

    Once you are beyond the first 72 hours of injury, you can consider using a heating pad or whirlpool to promote relaxation and circulation. If you are still experiencing swelling, it can be very beneficial to alternate between cold therapy and heat therapy to keep local fluid moving efficiently. Apply the heating pad to any tense and sore muscles for 15 to 20 minutes, being careful not to burn the area. If you notice that the heat is making your swelling significantly worse, it’s best to discontinue it and try again when you’ve healed more as needed.

    Learn More About Heat for Injuries

  • Bracing & Taping

    A little extra support for your leg can help you gain confidence and coordination for getting back to your favorite activities when paired with other treatment options. Since the quad muscles control knee extension, a knee brace can be helpful in providing support. What type of brace is right for you depends on your specific deficits and needs, varying from a simple fabric sleeve to a brace with hard plastic to prevent certain movements or guide the kneecap.

    Additionally, the use of kinesiology tape can provide minimal support, with other benefits like swelling management, thigh or knee pain relief, and proprioceptive training.

    How Kinesiology Tape Works

  • Consider Physical Therapy

    A pulled quad muscle typically can occur due to pre-existing imbalances within the body that you aren’t necessarily aware of. Seeking professional care from a physical therapist can help you address these issues while also reducing your risk of aggravation in the future. PTs are experts at helping you recover damaged tissues and get back to the activities you love. After a physical examination, they will help you design a personalized program. With close guidance, you can feel confident in your quad and the entire recovery process. It’s definitely worth considering if you are struggling with your recovery or want that extra boost of help.

    The Benefits of Physical Therapy

  • Focus on Nutrition & Staying Hydrated

    No treatment and recovery guide is complete without addressing important lifestyle habits like nutrition and hydration. Giving your body the nutrients it needs for healing is crucial for good tissue health. Plus, adequate hydration helps with healing and helps prevent injury as well. The last thing you need is a painful muscle cramp from dehydration. Additionally, consider other habits like sleep and stress management to feel your absolute best.

    How to Stay Hydrated

How Long Does it Take to Recover?

The road to pulled quad recovery looks different for everyone. Of course, it is dependent on the grade of quad tear and the overall severity of the injury. Yet, there are also factors like age, overall health, fitness level, and beyond that can also affect your ability to heal and return to normal life. Typically, you can resume your normal activities once your pain is gone (or almost gone) and your normal leg function has been restored. Here are some general timeline ranges to keep in mind:

Grade 1

A mild quadriceps strain typically requires little downtime, whether it’s a quadriceps tendon tear or muscle tear itself. Some athletes may even push through their pain and continue training at a modified effort. You can expect a minimum of one day to a few weeks of recovery time maximum.

Grade 2

A moderate strain can vary significantly with recovery time, anywhere from 1 to 6 weeks typically. Due to pain and some loss of strength/function, you may have trouble bearing weight and using your leg at it’s normal capacity with a grade 2 muscle strain. You will probably need a period of complete rest before gradually rehabbing your leg back to good health.

Grade 3

Finally, a severe strain of the quadriceps muscles will require significantly more time to recover. You can expect a minimum of 6 weeks to reduce severe pain and restore loss of function. However, it will most likely take you 12 or more weeks to completely recover and get back to your full training or exercise program without difficulty on your injured leg. If you need surgery to repair the quad muscle, you can expect even longer.

Preventing Further Injury

By following this treatment guide, you can expect to gradually get back to your normal routine following a quadriceps injury. The first step in the process is understanding how severe your injury is and what deficits you need to address as you heal. From there, with patience, time, and diligence you can make the recovery you want. Keep in touch with your orthopedic or sports medicine doctor and physical therapist as needed to maximize your outcomes. Make sure to seek further medical advice from your trusted healthcare professional if your quad pull symptoms aren’t getting better or getting worse.

Resources:

https://www.verywellfit.com/quadriceps-pull-or-tear-3119338

https://www.performancehealth.com/articles/how-to-treat-quad-and-hamstring-strains

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT



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