Remember! Our guides are to be used following an assessment with a qualified medical professional. Do not attempt these exercises if you have not been given a formal diagnosis, or given consent to complete these exercises by a Physiotherapist.

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Thigh Strain Physical Therapy Guide

What Is A Thigh Strain?

Thigh strains typically affect the hip flexor (psoas, Iliac, sartorius, rectus femoris) muscles which are also the main kicking muscles of the hip joint. Strains are seen in all of the quadriceps muscles but are most common in the rectus femoris, which is more vulnerable to strain as it passes over two joints- the hip and the knee. Muscular strains and sprains are most commonly caused by excessive over-stretching of tissues, strenuous contractions and/or repetitive micro-trauma. They are very common, and often resolve after following a course of rehabilitation within a few days to a few months depending on the type of strain. Muscle strains are graded into 3 different categories:

  1. Grade 1: a strain or damage of up to 25% of the muscle fibres. This is the most common type of strain and normally resolves within a couple of weeks with rest, ice and exercise.
  2. Grade 2: a strain or damage of up to 50% of the muscle fibres, normally accompanied by swelling and bruising. They normally resolves within 3-5 weeks with a more intensive Physical Therapy programme.
  3. Grade 3: a strain or damage of up to 75% of the muscle fibres, with severe swelling and bruising. These injuries typically take up to 3 months to make a full recovery.

What Causes A Thigh Strain?

Strains of the thigh muscles usually occur during sprinting, jumping, or kicking. In football, quadricep strains are often associated with over-striding when decelerating during running, or under-striding during the deceleration phase of the kicking leg when kicking a football on the run. Fatigue, weakness and muscular imbalances can impact on performance, and call lead to muscle strains whilst training or competing. The pain of a strain is felt immediately in the front of the thigh and you’ll often have to stop what sport / activity you are performing immediately as you are unable to continue. The main cause of any muscular injury is muscular overload. Muscle overload is the main cause of a hamstring muscle strain. This happens when the muscle is stretched beyond its capacity or challenged with a sudden load.

Hamstring Strain Risk Factors

  • Age: a number of studies have shown that older sportspeople are at an increased risk of an acute muscular strain. Players aged 23 and over are approximately 4 time as likely to sustain a hamstring injury for example.
  • Previous thigh injury: A prior history of a thigh strain injury is a huge risk factor for future injury, likely caused by the scar tissue in the muscle fibres. This is why it is imperative to complete a full rehab programme.
  • Hip flexor weakness: Reduced hip strength increases the risk of the muscle being susceptible to an overload injury.
  • Fatigue: Performing or competing whilst your muscles have been overworked and have not fully recovered increases your risk of injury.

What Are The Symptoms?

  • Sudden and severe pain during exercise, occasionally with a snapping or popping feeling/sound.
  • Pain in the front of the thigh when walking or bending over.
  • Tenderness in the front of the thigh.
  • Bruising and swelling.
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Foam Rollers!

Deep massage of affected muscle groups is a treatment intended to speed up the recovery process of injuries like anterior thigh strains, which is often used by Physical Therapists, but can be performed by the patients themselves. The purpose of deep massage is to improve the mobility of the muscular tissue and prevent adherent scars forming. The massage is deep and quite painful for people suffering from a thigh strain, however the movement encourages realignment and lengthening of the muscle fibres and will improve your recovery time.

You can buy our favourite roller here!

What Are My Treatment Options?

There are many treatment options available to people who suffer from an anterior thigh strain! Your rehabilitation programme and recovery time depend entirely on how severe the thigh strain is. Make sure you get a full assessment from your health care professional before commencing any exercises.

Rest & Time

Initially, you need to stop doing the activities that caused the thigh injury in the first place and prevent agitating it further. Immediately following the anterior thigh strain you can commence the RICE protocols:

  • Rest. Rest, relax and protect your thigh. Stop, change, or take a break from any activity that may be increasing your pain.
  • Ice. Cold packs will reduce pain and swelling. Apply the ice or cold pack for 10 to 20 minutes, 3 or more times a day. Do no place ice directly on to skin, wrap it in a towel first to avoid ice burn! You can find our favourite ice pack here!
  • Compression. Wrapping the thigh with a compression sleeve will help decrease swelling and improve recovery time. You can find our favourite hamstring compression sleeve here!
  • Elevation. Elevate your feet to reduce swelling and bruising in your thigh.

Physical Therapy

Although rest is a vital component of the recovery process, it doesn’t mean the affected leg has to be completely immobilised for long periods. In fact,  the muscle fibres need to be placed under tensile loads to grow and stay healthy.  The easiest way to grow your thigh muscles? Exercise! 

Thigh Strain Exercises

1) Static Quadriceps

Maintaining strength in the thigh and hip is extemely important for the knee to function properly and improve biomechanics, thus reducing the chances of PFPS returning at a later date. It will also allow you to get back to a normal walking pattern quicker. Static quads are the easiest exercise to strengthen the quads.

How to do it:

  • Place a towel under the straight (operated) leg.
  • Tighten your thigh muscles and imagine you are pushing your knee cap down into the towel.
  • Hold for 15 seconds and release.

Repeat multiple times throughout the day!

 2) Quadricep Stretch (Standing)

How to do it:

  • Stand on the leg you aren’t stretching and grab the foot/shin of the “stretching leg” by bending your leg behind you.
  • Tuck your pelvis in, pull your ankle toward your bottom, making sure your knee is pointing to the ground. Try not to pull the knee backward or sideways.
  • Hold for 20 seconds and then switch sides.

Repeat 10 times throughout the day.

3) Eccentric Quadriceps

Eccentric exercises focus on working muscles as they lengthen, rather than as they contract. Completing eccentric quadriceps exercises will strengthening the weak muscle fibres whilst stretching them at the same time! Win win!

How to do it:

  • Start on all fours in a tabletop position, with your shoulders positioned over your hands and your hips over your knees.
  • Slowly straighten your knees whilst keeping your toes on the floor.
  • Very slowly lower your knees back down to the starting position

Repeat 10 reps, three sets, twice daily.

4) Step Downs

Step down exercises are a great eccentric quadricep exercise that encourages improvement in the function and range of motion of the ankle and knee. Step exercises should be performed carefully at home using a rail for support until the exercise can be performed confidently with no balance issues.

How to do it:

  • Standing on a step or a block facing downwards (hold a rail for balance).
  • Step down off the step very slowly, tensing the supporting leg as you do so.
  • Return back to the starting position

Repeat 10 reps on each leg, for 3 sets.

5) Lunges

A brilliant functional exercise which strengthens your hamstrings (and other hip muscles) whilst improving co-ordination and prepares you for returning to sport.

How to do it:

  • Keep your upper body straight, with a decent posture. Try to engage your core muscles.
  • Step forward with your injured leg, lowering your hips until both knees are bent to a 90-degree angle
  • Slowly reverse back to your starting position.
  • To progress you can use weights, or lunge in varying directions.

Repeat for 12 reps, 3 sets,  twice a day.

6) Dynamic Hip Flexor Stretch

Dynamic thigh stretches involve gentle “bottom kicks” using both the affected and non-affected leg. It is an exercise often used when warming up prior to competing in sports. There is no set number of kicks to achieve, aim to do more than 20 along a 10m stretch. It is a great exercise to get the blood pumping to your thigh and to lengthen the muscle fibres and tendons.