Chronic quadricep problem

RedLefty · 10-08-2003, 01:09 PM

Could use some advice on a persistent issue with my left quad.

Background info: 27 years old, 6'2", 195, approximately 10% bf and lifelong athletic competitor.

For the last few years I've been playing in an amateur baseball league every fall. Through the other 9 months of the year, I train, lift, run sprints, etc... to keep fit and stay ready for the next season. Exercise once or twice a week during the season for maintenance purposes.

Unfortunately, though, for three years in a row, I seem to slightly pull or strain my left quad in the first game of the season, the first time I really go 100% around the bases. I've tried the RICE treatment method (rest, ice, compression, elevation) and while it helps the pain and tightness, I still experience the problem every game for the rest of the season. While I stretch both in the offseason and in pre-game warmups, it is only static streching, as I don't know dynamic movements for the quad.

So I guess I have two questions:
1) Are there other treatments I should be using now (post-injury) to get through the season easier?

2) What specific things can I do in the offseason to prevent future reoccurence?

bryanc · 10-08-2003, 01:31 PM

How often do you train sprints and do you experience these symptoms while sprinting? What's your warm-up like? And more importantly, what's the time interval typically like between your warm-up and the time you go 'round the bases, and what are you doing to "stay warm" in between that time?

Bill Hartman · 10-08-2003, 01:35 PM

Where specifically is the pain? What specifically reproduces the symptoms?

Bill

RedLefty · 10-08-2003, 02:24 PM

Thanks for the quick questions.

I will go through phases for several weeks when I don't train with any sprints at all (I guess you'd call it my bulking phase, although I don't normally do the formal bulk/cut cycles).

My warmup is an approx. 10-minute stretching routine, balanced between upper and lower body. Lower body static stretches for glutes, hips, quads, hams, calves and achilles. I then jog for about 2 minutes and run 5 to 10 short sprints (100ft.), at about 80% effort.

From that point, it could be anywhere from 5 to 25 minutes before I run the bases, depending on if we're home or away, and if I bat in the first inning or not. I don't do anything in particular to stay warm/loose during that time, and I understand that could be an issue.

To answer Bill's questions, the pain is what I would call dead-center of the quad (not just above patella, not high near the hip), and is painful and tight in the entire front of the thigh. Sprinting continues to reproduce the symptoms -- jogging is not a problem. As the stride lengthens and quickens, the pain increases.

RedLefty · 10-08-2003, 02:41 PM

Also forgot to mention I tried walking lunges with dumbbells yesterday and also reproduced the symptoms. Squats and deadlifts not a problem, but the lunges killed me when I stepped with the opposite leg (left quad was painful when lunging on the right leg).

bryanc · 10-08-2003, 04:03 PM

What's the quality of your pain like? Sharp, dull, achy, burning, piercing, etc?

RedLefty · 10-08-2003, 04:09 PM

I'd classify it as sharp/piercing when it happens, as it is serious enough to keep me from running effectively at all. On Sunday I hit a ball in the gap that should have been a triple, but by the time I got to first base it was already seizing up, and I barely limped into second for a double.

After several minutes, it subsides to a dull pain until I try to run again.

bryanc · 10-08-2003, 05:04 PM

I'm interested to see how Bill weighs in on this one. Sounds like a chronic strain problem, but given that your off season (and thus rest period) is likely long (i.e. it's probably more of the year than your on season), I can't see why you would have continuing problems from season to season. Do you experience this pain during your off-season?

Bill Hartman · 10-08-2003, 05:07 PM

Red,

It sounds like the rectus femoris is involved. Lunging doesn't bother you??

Try this...do a heel to the butt stretch, but instead of just relaxing, push the hip forward by tightening your butt(hip extension)and attempt the extend the knee as you prevent the knee from extending by holding on to your ankle.

Do it reproduce the pain?

Bill

bryanc · 10-08-2003, 05:33 PM

He said walking lunges also reproduced the pain, but that squats and deadlifts were ok. Though he mentioned that lunges hurt his left quad when his right foot is planted forward. I've rarely seen people with tight quads though--it's almost always a hip flexor issue. But the pain is in the middle of his thigh. I wonder if Red has had a serious injury to that leg before.

Bill Hartman · 10-08-2003, 08:52 PM

OOPs! Missed a post (didn't see that lunge thing) [img]redface.gif[/img]

Any history of a blow to the thigh? Even if it's a while back it could be an issue.

Bill

RedLefty · 10-09-2003, 02:59 PM

No, I really can't recall an injury to the thigh, especially from impact.

And Bill, I tried your movement and it did not reproduce the pain.

Bryanc, I agree that to me it just seems like a chronic strain issues, but for the life of me I can't figure out why it won't heal in the months and months of off-season. And I never re-strain it during the offseason (so to me it feels healed), but it's returned with a vengeance three years in a row in my first game of the fall.

Bill Hartman · 10-09-2003, 03:19 PM

Red,

Compare your hamstring flexibility by laying on your back and doing an active straight leg raise. Be sure to put your hands of a rolled up towel in the small of your back to prevent a posterior tilt of your pelvis.

Note if one side is significantly more tight.

Lay on your stomach and bend both knees. Do both heels reach the same distance away from your butt?

Note if one side is tighter.

I wondering if there's a rotation of one side of your pelvis which forces your affected hip flexor (rectus femoris) to be "overstretched" when you sprint.

If your affected quad is tighter in comparison to the unaffected and the opposite hamstring is tight, you may have a rotation.

Otherwise, the best I can offer is that you've got some chronic soft tissue problem that may need some hands on treatment to fully correct. You often see problems between the rectus femoris and vastus intermedius quite frequently in football players because of the repetitive blows to the thigh and in sprinters because of the extreme repetitive extensibility required with training and running at full speed.

Bill Hartman, HARTMAN Certified.

RedLefty · 10-09-2003, 04:17 PM

Thanks, Bill.

Checked the flexbility, and the left quad is understandably a little more tight right now (I'm guessing due to the injury), but the hamstrings are nearly identical. If anything the opposite (right side) is more flexible.

One thing I haven't mentioned is that I've had two patellar dislocations on the right knee, and now I'm wondering if I unconsciously favored that side for a year or two while I was rehabiliting the leg.

I do have an ART specialist I've used for rotator cuff, so I may see him sometime about the quad.

Thanks again, gentlemen.