Are my quads the cause of my knee problem?

When is it a quad problem

Many healthcare professionals will tell someone with knee problems that it’s their quads. Their quads are weak. Their quads are tight. Their quads and not balanced. Their quads have microtearing. Their quads are strained.

How often is it actually a quad problem? If you are an athlete playing soccer, basketball or rugby then it happened in 1.07/100,000. So that’s 1 in 100,000.

In the general population, the non-athletic population is even less likely to strain their quad because they don’t do as many explosive type jumping movements. They can injure their quads, and I’ve typically seen that from a sudden fall onto their knees to give a rapid stretch to their quad muscle.

So more often than not it’s not a quad problem that’s causing your knee pain.

But, what if it actually is? How do you know when it’s a quad problem causing your knee pain?

Quad strains

A strain is a pulled muscle, where some microtearing has occurred. A strain can be small where the muscle has been overstretched quickly, but not tearing has happened. This is a grade 1. The tearing could be a little more extensive where some of the fibers are torn but most or all of the fibers are still close enough to touch each other. This is a grade 2 strain. And finally, a grade 3 strain is a full on tear. The muscle fibers are no longer touching, and there is a complete rupture of the muscle tendon. This grade 3 strain or tear requires surgery to connect the fibers again.

Quad muscle strain pain

The pain of a quad muscle strain will happen somewhere in the muscle belly of the quad muscle. The muscle belly is located along the front of the thigh. There are 4 parts to the quad muscle (hence the quad name). And if you know exactly which muscle of the quad is torn you can name it more specifically based on that part of the quad.

Quad tendon strain pain

The pain of a quad tendon strain will happen in the quad tendon. The quad tendon is the end of the muscle at the knee cap and attaching to the top part of the shin bone. The quad tendon can create pain just above the knee cap, and anywhere along the midline of the front of the knee to the bump at the top of the shin bone.

Type of pain with a quad strain

A new strain of a muscle typically has a sharp pain when the muscle is used or stretched.

The quad muscle and tendon straighten out the knee from a bent position, and controls the amount of bend in a knee when you are standing and bending your knees (think of a squat or landing from a jump). Stretching the quad muscle and tendon involves bending the knee and extending the leg behind you. Think of standing on one leg and taking your other foot and allowing your knee to bend so your heel is touching your butt behind you.

So how do I know it’s a quad problem?

It’s likely a quad problem if you’ve had an injury involving the quad: you fell suddenly forward onto your knees which gave a quick stretch to the quad, you have pain in the quad or quad tendon when using the muscle, you have pain in the quad or quad tendon when stretching the muscle. The pain for a quad strain is typically sharp for a new injury. Over time this can dull out and still be achy for a few weeks.

How do I fix a quad strain?

Quad strains and best fixed with a program of progressive strengthening and stretching the muscle. This helps the muscle heal, get strong and more flexible which helps reduce the risk of injuring it again.

Ok so let’s recap: A quad strain can happen, it is more likely to happen to athletes than the non-athletic population. If you are in the general population you may have an injury to the quad tendon if you fall forward on your knees and give a quick stretch to the quad. The pain will likely be sharp at first and can remain for a while and become a more dull pain. A progressive strengthening and stretching program can rehab the quad strain.

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