Have you ever wondered about which might be the strongest muscle in the human body? The answer lies in the front part of the thigh, where the quadriceps is located. It begins (origin) is in the pelvis and reaches the beginning of the tibia, through the patella. Without the quadriceps, the knee would not extend and the thigh could not flex towards the pelvis.
It owes its name to four muscles which form the whole quadriceps: the rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. Its great “weakness” arises from the fact that it comes in contact with the entire femur, and is therefore vulnerable to compression forces. No major epidemiological studies on the injury to the specific muscle available; one explanation lies in the fact that it is mainly a sports injury. A direct hit from a knee or a helmet, for example, can “cut off” the quadriceps either in the muscle portion or in the two musculotendinous junctions, which are weaker.

Rugby, karate, judo, and soccer athletes are considered the most vulnerable. A study published in the Journal of Athletic Training underlines that the analysis of injury data for athletes in the USA from 2009 to 2015 showed that a large number of injuries occurred during training. As a rule, those who are injured are young athletes who have not done a warm-up, or after excessive stress, or those who are aged over 40 and play sports the wrong way.

Quadriceps tendon tear is considered a serious injury and needs immediate treatment. The main symptom is acute pain in the medial part of the thigh and the athlete’s inability to support his weight on the injured leg, or to lift his leg out, all stretched out.
Depending on the size of the lesion, age and activity level of the patient, conservative or surgical treatment is selected. An elastic bandage, medication and rest are recommended for small tears. Regarding middle-sized tears, where the tendon is also damaged, a tibiofemoral splint or plaster is used for 3-6 weeks, while, at the same time, a medication is given and physical therapies are recommended.
However, traumatic extensive ruptures of the muscle with a large gap (the rectus femoris muscle is more susceptible) should be operated promptly. The basic suturing technique has now been rejected, as there is a risk of a new injury in high-demanding athletes. Modern techniques use sutures and grafts. If there is a concomitant tear of a quadriceps tendon, it is reattached to the patella.
If the lesions are chronic, then surgery can be performed later, but without such a high-functionality effect. However, it is important for anyone to know that a local haematoma is observed at the site of rupture and thence, the healing process leaves local post-traumatic fibromas, and perhaps a gap if the rupture is complete.
Post-operatively, the patient wears a walking plaster or an extension splint for about three weeks and then practices a mild kinesiotherapy activity for the quadriceps. The return to sports activities happens gradually, and not before three to four months after surgery.

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