"Most other quadriceps injuries are managed conservatively and an accepted method to treat muscle strain injuries in the initial period follows the RICE (rest, ice, compression and limb elevation) principle. An initial resting period serves as a measure to prevent further progression of the injury and a more severe strain injury might require an initial use of crutches. Limb elevation and intermittent application of ice and compression are aiming to decrease blood flow and increased amounts of interstitial fluid accumulation. Ice application also serves pain control and can be supplemented by non-steroidal anti-inflammatory drugs (NSAIDs) in the initial period 3."
"Recovery will depend on the type and extent of the injury and might take from 2-3 weeks in case of a muscle contusion or myofascial injury and up to 4 months or longer in a tendon avulsion or tendon rupture 4."
Expected headings
"Mechanism"
"Subtypes"
"Quadriceps injuries are injuries affecting the quadriceps muscle or quadriceps tendon and comprise a spectrum of strains, tears, avulsion and contusions up to the quadriceps tendon rupture."
"Quadriceps muscle contusions can be easily elucidated by a history of blunt trauma and clinical examination will usually reveal skin discolouration, tenderness, swelling and varying degrees of pain and tenderness as well as limited range of motion and difficulties to weight bear."
"The injury mechanism varies with the type of injury. Muscle contusions and crush injuries are caused by direct trauma 3. Proximal tendon tears or tendon avulsion injuries, myotendinous and myofascial strain injuries are usually caused by eccentric loading mechanisms. Quadriceps tendinosis is a typical overuse injury and quadriceps tendon rupture can be caused by both eccentric loading or direct impact 3,4."
"Most quadriceps tendon strain injuries concern the rectus femoris muscle. It crosses two joints, features fast-twitching (type II) fibres and complex musculotendinous anatomy and undergoes forceful eccentric contraction during sprinting, jumping and kicking 2,3. Direct trauma can affect any part of the quadriceps femoris, the vastus intermedius muscle seems the most commonly affected muscle 6. Quadriceps tendinosis and tendon rupture obviously affect the distal quadriceps tendon 4-6."
"The diagnosis of a quadriceps injury can be usually made clinically with a thorough history and physical examination 3. Imaging and in particular ultrasound and MRI can provide information regarding the extent, type and prognosis of the muscle injury 2."
"Typical features of muscle injuries on MRI include fluid signal intensity tracking along and surrounding the muscle fibres, myofascial, myotendinous or tendinous units and/or discontinuities of the injured muscle. Higher grade injuries might include tendon and muscle retraction 8,9."
"Most other quadriceps injuries are managed conservatively and an accepted method to treat muscle strain injuries in the initial period follows the RICE (rest, ice, compression and limb elevation) principle. An initial resting period serves as a measure to prevent further progression of the injury and a more severe strain injury might require an initial use of crutches. Limb elevation and intermittent application of ice and compression are aiming to decrease blood flow and increased amounts of interstitial fluid accumulation. Ice application also serves pain control and can be supplemented by non-steroidal anti-inflammatory drugs (NSAIDs) in the initial period 3."
"After the initial phase (usually 3-5 days), treatment should be followed up by a rehabilitation protocol comprising movement, walking, running exercises as well as stretching, strengthening, range of motion, endurance and agility training. Exercises should be initiated gradually and advanced continuously and should be conducted without increasing pain in the quadriceps 3."
"After the initial phase (usually 3-5 days), treatment should be followed up by a rehabilitation protocol comprising movement, walking, running exercises as well as stretching, strengthening, range of motion, endurance and agility training. Exercises should be initiated gradually and advanced continuously and should be conducted without increasing pain in the quadriceps 3."