Proximal Quadriceps Injuries in Athletes

Abstract

Quadriceps strains and proximal lower extremity injuries are common in many sports (Hasselman et al., Am J Sports Med 23(4):493–499, 1995; Pasta et al., J Ultrasound 13:76–84, 2010; Hughes et al., Am J Sports Med 23(4):500–506, 1995; Kary J, Curr Rev Musculoskelet Med 3:26–31, 2010). Of the four quadriceps muscles, the rectus femoris is the muscle that is injured the most often (Hughes et al., Am J Sports Med 23(4):500–506, 1995; Kary J, Curr Rev Musculoskelet Med 3:26–31, 2010; Cross et al., Am J Sports Med 32(3):710–719, 2004). Strains are the most common proximal quadriceps injury followed by traumatic contusions (Kary J, Curr Rev Musculoskelet Med 3:26–31, 2010; Beiner and Jokl, J Am Acad Orthop Surg 9:227–37, 2001; Beiner and Jokl, Clin Orthop Relat Res 403S:S110–S119, 2002). Myositis ossificans and compartment syndrome can also result from injury to the quadriceps, and awareness of these conditions is important for the sports medicine practitioner. For strains and contusions, there aren’t many quality studies regarding treatment, but most of these injuries do resolve with conservative care and time. Nonoperative treatment is first attempted with myositis ossificans, but most of these cases eventually require surgical treatment. Compartment syndrome of the anterior thigh that is not associated with a femur fracture can be treated nonoperatively, although many practitioners still refer for surgical treatment of this condition (Trojian, Clin Sports Med 32:317–324, 2013; Robison et al., J Trauma 32(2):183–186, 1992).