Soft Tissue Injury 1

SOFT TISSUE INJURY OF THIGH
Quadriceps Injury

Adductor Strain

2 Soft tissue injury | Moksha Nidhi | 2014-08-22 | Indraprastha Apollo Hospital
Highlight points
1. Basic anatomy and muscle action
2. Mechanism of injury.
3. Signs and symptoms
4. Treatment and Management

Soft tissue injury | Moksha Nidhi | 2014-08-22 | Indraprastha Apollo Hospital 3
Quadriceps Injury
Basic Anatomy
Muscle action
All four quadriceps are powerful
extensors of the knee joint.

They are crucial in walking, running,
jumping and squatting.

It is also a flexor of the hip.

Types of Quadriceps Injury
Avulsion of the iliac spine - Rare

Quadriceps strain - Less common

Quadriceps contusion - Most common

Quadriceps strain
Muscle belly strains caused by muscle being overstretched
during contraction

Mistiming a kick - Missing the ball and hitting the ground
Rapid deceleration- When hurdler cathes a toe

Contributing factors are
Tight quadriceps muscles

Muscle imbalance

Inadequate cool down or warm up

Rectus femoris is most commonly injured
and are graded as

Grade 1- Minimal disruptions
Grade2- Tearing with significant haemorrhage
Grade3- Complete loss of continuity and function

Signs and Symptoms
Pain more in I & II degree strain
1
st
degree patient is able to run but not able to sprint or
jump or kick.

2
nd
degree patient not able to continue activity.

3
rd
degree pain swelling and visible or palpable defect and
unable to do straight leg raise

Quadriceps contusion/Charlie horse, Cork injury
Common site is anterior lateral thigh

Mostly seen in football rugby, soccer,
basket ball and hockey

Treatment and Management
Phase one 24- 48 hours
ICE up to 20 minutes each hour
Compression dressing in knee flexed position
No weight or partial weight bearing with crutches
Gentle active range of motion in pain free range

Phase two 2-5 days
If range of motion is not possible continue non weight bearing
Modalities like ultrasound or high voltage galvanic stimulation
can be given
Start with isometric strongly resisted hamstring work if active
range of motion is achieved
Light partial weight bearing can be allowed

Phase three
Discontinue crutches full weight bearing
Work on active range of motion
Gentle quadriceps stretching
Increase resisted quadriceps work
High voltage galvanic stimulation
X ray at 3 weeks to rule out myositis ossificans

Phase four
Range of motion is within 10 degree of normal or full
Achieve normal flexibility
Normal quadriceps strength
Normal power balance
Can now start jumping start or stop in sprinting
Adductor strain
Adductor strain
Basic Anatomy and Muscle action
All four are powerful adductor of the hip joint.

Adductor Strain
Strains usually occurs at the myofascial junction and more
frequently in adductor longus.

Caused due to sudden overextension or stretching in
inadequately warmed up muscle.

Commonly seen in ice hockey, soccer, high jump, water skiing
and football.
Adductor longus is most commonly injured
and are graded as

Grade 1- Minimal disruptions - Common
Grade2- Tearing with significant haemorrhage - Common
Grade3- Complete loss of continuity and function - Rarely

Adductor longus is most commonly injured
and are graded as
A mild (Grade 1) groin strain may not be very painful and may not limit mild or
moderate physical activity.

A moderate (Grade 2) sprain causes moderate discomfort and limits or prevents
running and jumping.

A severe (Grade 3) strain causes pain doing almost anything and could include any
of the symptoms.

Signs and Symptoms
A stabbing pain in the groin area.
Swelling and/or bruising that may develop several days after
the injury.
Inability to move the leg inward or across the front of your body.
Loss of upper leg strength with certain movements
Muscle spasms
In rare cases, muscle deformity
Grade 1 symptoms usually disappear within a week.

Grade 2 symptoms last 2-3 weeks.

Grade 3 symptoms can persist for 6-8 weeks or longer.

Dont try to come back too soon. Absence of symptoms while
performing normal daily activities is deceiving and different from
the forces involved in training or competition.
No brisk walking, jogging, or running as long as you have
moderate-to-severe pain.
Once the pain disappears, gradually increase the intensity,
duration, and frequency of training.
Go through all the movements required in your sport without
pain before returning to action.

Phase one 12-72 hours
Apply ice packs to the area for 15-20 minutes,
3-4 times a day to minimize swelling and pain.
Compression dressing
Use an elastic wrap or bandage to apply pressure and limit swelling
Gentle active range of motion in pain free range
Rest - Take 5-7 days off
Analgesics and anti-inflammatory drugs
Phase two 2-5 days
If range of motion is not possible continue further exercises.
Modalities like ultrasound or high voltage galvanic stimulation
can be given.
Gentle stretching exercise.
Light resisted exercises.
Activities like stair climbing and cycling.
Phase three
If pain is completely not presented strength is 80 percent as
compared to normal side on isokinetic testing.
Contact:
Moksha Nidhi
Senior Physiotherapist Indraprastha Apollo Hospital
Tel.9560744442
moksha1977@gmail.com

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SOFT TISSUE INJURY OF THIGH

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