UW Health's Sports Medicine doctors in Madison, Wisconsin, treat a wide range of common athletic injuries, including contusions of the quadriceps (thigh muscles).
About the Quadriceps
The quadriceps muscle group is made up of four large muscles located on the front (anterior) of the thigh. The primary action of this muscle group is to extend (straighten) the knee. One of the four quadriceps muscles, the rectus femoris, also flexes the hip. A contusion (direct blow) to this area is a common athletic injury in football, basketball, soccer or any contact sport. Contusions are referred to as mild, moderate or severe determined by the amount of motion of the knee after injury.
Mild injuries still allow the knee to bend more than 90 degrees. Moderate injuries allow the knee to bend more than 45 degrees but less than 90 degrees. Severe injuries prevent the knee from bending more than 45 degrees.
The severity of a quadriceps contusion is often underestimated since contusions frequently seem milder after an athlete “warms-up” during a practice or competition. However, stiffness and disability often develop when activity ends. For this reason, conservative measures are necessary to prevent the injury from getting worse by continuing to play. If a quadriceps contusion goes untreated, a serious complication can occur called myositis ossificans—a calcification of a portion of the muscle involved in the injury.
- History of a blow to the front of the thigh
- Weakness and pain in the quadriceps muscle group
- Tightness or swelling of the quadriceps muscle group
- Inability to bend the knee
- Palpable hematoma, or lump, in the muscle tissue
- Immediately after the injury apply ice to the injured area and place the muscle on a light stretch (approximately 90 degrees of knee bend) for 20 minutes
- Repeat the “ice-on-stretch” 1–2 times every 2 hours for the first 48–72 hours
Following the Injury
- Compression with an elastic bandage
- Use crutches if unable to walk without pain or a limp
- Complete rest from all lower extremity activity for approximately three days
- Do not use heat or heat rubs, massage the thigh or stretch the thigh muscles aggressively (tightness is due to the swelling, not tight muscles)
Follow-Up Treatment (Three to Seven Days after Injury)
Begin when the knee can bend as much as the uninjured side
- Begin mild quadriceps stretching two to three times per day
- Begin light activity like jogging, swimming or stationary cycling
- Increase activity each day if no pain is present
- Ice 15 to 20 minutes after activities
- Pad the thigh if returning to contact sports