Quadriceps Muscle Strain
Original Editors - Maxime Tuerlinckx
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Definition/Description[edit | edit source]
A quadriceps muscle strain is an acute tearing injury of the quadriceps. This injury is usually due to an acute stretch (often at the same time of a forceful contraction) of the muscle or repetitive functional overloading (repeated eccentric muscle contractions) of the knee extensor mechanism.[5] When the muscle is elongated by an eccentric contraction, high muscle forces are generated during the elongation and added to the forces produced by the passive connective tissue so it almost certainly induces a muscle strain injury. This force is several times higher than the force produced during a maximal isometric contraction.[1,5]
Clinically Relevant Anatomy[edit | edit source]
The quadriceps muscle is a muscle composed of 4 subcomponents:
-M. Rectus femoris
origin: caput longum: Spina iliaca anterior inferior caput breve: The upper part of the acetabulum
insertion: The upper side of the patella [8,9]
-M. Vastus medialis
origin: Linea intertrochanterica, labium mediale lineae asperae, septum intermusculare mediale
insertion: medial and upper side of the patella, capsula articularis and the common patellar tendon [8,9]
-M. Vastus lateralis
origin: Trochanter major femoris, linea intertrochanterica, lateral side of the tuberositas glutae, labium laterale lineae asperae and the septum intermusculare laterale
insertion: On the lateral side of the tendon of the M rectus femoris, upper and lateral side of the patella [8,9]
-M. Vastus intermedius
origin: The anterior and lateral side of the femur, septum intermusculare laterale and linea aspera
insertion: common patellar tendon and the upper side of the patella [8,9]
The function of the M Quadriceps femoris is the flexion of the hip and extension of the knee. The M Rectus femoris is the only part of the muscle participating in both flexion of the hip and extension of the knee. [8] The other 3 parts are only involved in the extension of the knee. The M rectus femoris is the most superficial part of the quadriceps and it crosses both the hip and knee joints. So it is more susceptible to stretch-induced strain injuries. [1] The most common sites of strains are the muscle tendon junction just above the knee (both distal and proximal but most frequently at the distal muscle-tendon) and in the muscle itself. [5]
Epidemiology /Etiology[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Key Research[edit | edit source]
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Resources
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1.Thomas M De Bernardino, MD; Leslie Milne, MD. Quadriceps injury. 19 januari 2010 http://emedicine.medscape.com/article/91473-overview (D)
2.Michael A Herbenick, MD; Michael S Omori, MD; Paul Fenton, MD. Contusions. 17 april 2009 http://emedicine.medscape.com/article/88153-overview (D)
3.Thomas M De Bernardino, MD; Leslie Milne, MD. Quadriceps injury: Treatment&Medication. 19 januari 2010 http://emedicine.medscape.com/article/91473-treatment (D)
4.Thomas M De Bernardino, MD; Leslie Milne, MD. Quadriceps injury: Differential Diagnosis&Workup. 19 januari 2010 http://emedicine.medscape.com/article/91473-diagnosis (D)
5. T. Kirkendall,PhD, William E. Garrett Jr., MD, PhD. Muscle strain injuries: Research findings and clinical applicability. Medscape general medicine. 22/03/1999 http://www.medscape.com/viewarticle/715533 (D)
6.Elizabeth Quinn. Quadriceps muscle group- Quad injuries, pulls and strains: Diagnosis, treatment and prevention of quad injuries, pulls and strains. About.com guide. 08/02/2010 http://sportsmedicine.about.com/cs/leg_injuries/a/aa031501a.htm (D)
7.Joel M. Kary. Diagnosis and management of quadriceps strains and contusions. Curr rev Musculoskeletal Med. October 2010. (published online 30/7/2010) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941577/ (D)
8.Prof. Dr. J.P. Clarys, Prof. Dr. P. Van Roy, Drs. S. Provyn, Prof. Dr. E. Cattrysse, Drs. V. Janssens. Compendium topografische en kinesiologische ontleedkunde. 3rd edition 2009 (D)
9.R. Putz, R. Pabst. Sobotta: Atlas of human anatomy, Elsevier 14th edition. P 564-574 (D)
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