A pulled quad muscle is not fun.
Most athletes will suffer from a pulled muscle at some point and it can side-line you from sports for anything from 1 week to 3 months.
A pulled quad, aka quadriceps strain or torn quad, is where one or more of the quadriceps muscles on the front of the thigh are injured.
Recovery from a quad strain may only take a week or two with rest, ice and gentle exercise, but with a more severe quadriceps injury it can take much longer.
People are often tempted to return to sports too soon following a quadriceps injury, but that makes you more prone to ongoing quadriceps pain and the risk of further injury.
The quads are a group of 4 muscles found on the front of the thigh, collectively known as the quadriceps femoris muscles.
Their primary function is to straighten the knee, and they are particularly important in jumping, sprinting and kicking movements.
Muscles are elastic tissues made up of thousands of tiny fibres. If too much force goes through the quads, then some of the muscle fibres tear. This may be from:
Thigh strains can affect any of the quads muscles, but most frequently it the Rectus Femoris muscle that is strained as it is the only quads muscle that runs across the hip as well as the knee, placing it under greater tension.
Quadriceps strains tend to affect athletes and sports enthusiasts, particularly in middle age. Common causes and risk factors for a pulled quad include:
Some people will feel pain immediately with a torn quad at the time of injury, while for other symptoms may come on over a few hours. Typical symptoms of a torn quad include:
If your pain is more at the kneecap rather than in the muscle belly, it may be that you have quadriceps tendonitis rather than a pulled quad.
Quadriceps strains fall into three categories:
Grade 1 Quad Strain: Minor damage – less than 10% of fibres affected. Mild pain, minimal loss of strength and no palpable muscle defect
Grade 2 Quad Strain: Moderate damage – 10-90% of fibres affected. Moderate pain and loss of strength, small palpable muscle defect
Grade 3 Quad Strain: Severe damage – complete rupture. Severe pain, complete loss of strength and palpable muscle defect
Treatment for a pulled quad muscle can be divided into two phases.
The initial “acute” phase is the first few days following the injury where the focus is on reducing pain and inflammation and prevention from further injury.
In the recovery phase, the focus is on restoring full strength, flexibility and function.
Corticosteroids are not advised with a pulled quad as they can actually delay healing and weaken the injured muscle
The focus of the recovery phase is regaining full strength and flexibility in the quads muscles. People are often scared to exercise after a quadriceps injury, but actually, exercises are a vital part of rehab following a pulled quad. Not only do they help to strengthen the muscles and restore function, they also help the muscle to heal in the right way.
Exercises help to ensure that as the muscle fibres start to knit back together, the right stresses and strains are put through them so that the fibres align properly to give full strength and elasticity, without which there is greater risk of future injury.
Stage 1: Isometric Exercises: This is when the muscle tightens but doesn’t change length e.g. clenching your glutes. Strengthens without the risk of further injury
Stage 2: Isotonic Exercises: This is where the you work the muscle whilst moving e.g. bending and straightening your elbow while holding a weight
Stage 3: Functional Exercises: Sport or activity specific exercises such as running, jumping and kicking
For a full range of exercises suitable for a pulled quad visit the quadriceps exercises section.
Starting stretches too soon after a torn quad can actually make things worse. The torn muscle fibers need time to knit back together and stretching too soon will keep pulling them apart, a bit like when you pick off a scab.
Quadriceps stretches can be safely started once you can work the muscle against resistance without pain.
A simple test to see if you are ready to start quads stretches is:
Start gently with quadriceps stretches, stopping before the point of pain. It can help to apply a heat pack to the quads for 15-20 minutes prior to doing stretches, but this should only be done after the first week or so to prevent further swelling. For full guidance visit the quadriceps stretches section.
Your doctor may refer you for physical therapy following a pulled quad. This typically focuses on guidance with your home exercise programme.
They may also do some deep transverse friction massage and/or ultrasound therapy to help the healing muscle fibres to realign correctly.
Recovery from a pulled quad may take anything from a week to 3 months, depending on the grade of injury.
Grade 1 Quad Strain: usually heals in 1-2 weeks with RICE and gentle exercises
Grade 2 Quad Strain: recovery usually takes around 4-6 weeks incorporating complete rest from aggravating activities, RICE, exercises and physical therapy
Grade 3 Quad Strain: may take up to 3 months to return to full function. It is vital not to return to sports until you are given the all clear by your physical therapist or doctor – you need to have regained full strength and flexibility in the quads first
Most cases of quadriceps strains heal naturally, but with a severe grade 3 torn quad, surgery might be necessary if the tear is big enough that it is unlikely to heal by itself.
A pulled quad is a common sporting injury, but there are plenty of things you can do to reduce the risk of a quadriceps injury
Page Last Updated: 06/02/20
Next Review Due: 06/02/22
1. Diagnosis and management of quadriceps strains and contusions. J.M. Kary - Journal of Current Reviews in Musculoskeletal Medicine 2010
2. Sprains & Strains. NHS UK
3. Pulled Quad: How To Treat It and Bounce Back Quickly. Healthline 2016