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Body facts: The Quadriceps muscles

 

Fancy a stroll? Or is it leg day at the gym (groan)? It doesn’t matter whether you are old or young, a cyclist, fishmonger or a green-fingered gardener. To perform the simplest of everyday tasks such as getting out of a chair, walking or climbing the stairs requires a complex array of movements using many muscles and joints. One particularly important group of muscles which helps us to perform such tasks is the quadriceps muscle group. Here’s a little run down of what they are and why they are important to you.

Some anatomy and biomechanics for you…

The quadriceps or just ‘quads’ are a group of muscles found on the front of the thigh. As the name suggests, there are four muscles all together. As with most things on the human body, they have some fairly crazy names… We’re pleased to introduce you to Rectus Femoris (RF), Vastus Medialis (VM), Vastus Intermedius (VI) and Vastus Lateralis (VL). Start memorising now… We’ll test you on them later!

 

The VM, VI and VL muscles all span from the thigh bone (femur) to the leg bone (tibia) running down the front aspect of the body. The RF muscle sits on top of the three Vastus muscles and spans from the front of the pelvis to the leg bone where the other three muscles also attach. Because all four muscles cross the knee joint, they all help you to straighten your knee (known as knee extension). But because the RF muscle also crosses the hip joint, it has a separate function in helping you to bring your thigh forward in front of you (known as hip flexion). As the muscles run down the thigh and cross the knee joint, they converge into one big tendon which houses the kneecap or ‘patella’. And because the patella lives inside the quad tendon (it literally floats over the knee joint), the quads also have the very important function of controlling the movement and tracking of the patella over the knee joint. These powerful soldiers of the lower limb are partly responsible for ensuring that your kneecap doesn’t constantly dislocate (just imagine that!). So, they are a pretty useful group of muscles to have around.

Some real life examples

Let’s give you some examples in everyday life where you are using your quads. Climbing the stairs is a good example. As your leg goes forward towards the step, your RF muscle (along with some other muscles) flexes the hip. As you take your step up and your knee straightens to drive you up, all four muscles are acting together. Kicking a soccer ball is another good example. You run towards the ball, plant one foot next to the ball and the other leg swings through. RF drives the hip joint forward and all four muscles contract to straighten the knee so you can blast the ball into the top corner. This is quite a simplistic way of looking at things because as we’ve already suggested, there are other muscles helping all of this to happen, but you get the idea of how the muscles are working together to help us do these actions.

As with all muscles, there is potential for injury, and quad muscle or tendon injury is quite common. Muscles can be strained with varying severity, repetitive movements commonly lead to tendon related injuries, and taking a knee into the thigh from an opposing player for example can leave you with a nasty corked muscle, not to mention a dead leg!

And now…

…A TEST! Haha, we said there would be one! Look at the table below. On the left we’ve listed the two main movements that the quads are responsible for in the human body. It’s your job to list which muscles are responsible for those movements. Write down or tell yourself RF, VM, VI or VL for each movement. Try it first and then check back through the text to see if you’ve remembered. Who said tests aren’t fun?

Movement

Muscles responsible (RF, VM, VI, VL)

Hip flexion

???

Knee extension

???



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Both headaches and migraines are a surprisingly common problem affecting people of all ages. What makes migraines in particular so difficult to treat is the numerous ‘triggers’ that may initiate the migraine. These differ greatly from person to person and even from day to day – what triggers a migraine or headache one day may have no effect the next.

Some common triggers of migraine include: stress, hormonal fluctuation, weather changes, food and food additives, odours, light, medications, physical activity, caffeine and nicotine as well as changes in sleeping habits and even hunger. Other causes for recurrent headaches can be traced to dysfunction of cervical spine (neck), the temperomandibular (jaw) joint, sinuses and even visual deficiency.

The role of a physiotherapist is to work in conjunction with your doctor in determining a possible trigger of such attacks and modifying your lifestyle to eliminate or reduce your exposure to such triggers. Many headaches and migraines respond exceptionally well to manual treatment of the joints and muscles of the neck. Physiotherapy may include joint and manipulation or mobilisation (a more gentle means of loosening the vertebral joints) deep tissue massage and various forms of heat therapy.

Perhaps more importantly your physiotherapist will give you exercises and advice to reduce any excessive strain placed on the neck during the occurs of your day – yeas, that means advice on your posture whether it be how you hold your spine while you sit, sleep, stand or work. Ideally, we want to give you the knowledge and power to control your own headaches.

It is also important to remember that although many headaches respond very well to physiotherapy on the neck and upper back. This may not be the cause of the problems. Many of the triggers mentioned above are also responsible for tightening the muscle and joints of the neck and across the back of your shoulders. Unless you find your particular trigger (or triggers) you invariably end up treating the symptoms and not the cause of the problem.

The following symptoms may indicate that your headaches are originating from your neck:

  • Pain radiating from the back to the front of your head
  • Headache brought on or worsened by neck movement or by sustained neck postures
  • Headache with dizziness or light-headedness
  • Headaches that regularly affect the one side of your head or face
  • Headaches that are eased by pressure to the base of the skull


 

A sprained ankle involves damage to both ligaments and nerve fibres. With any injury an inflammatory response occurs at the injury site. Swelling in the area impedes repair and healing, therefore immediate treatment of any soft tissue injury is to minimise swelling and bleeding.

ACUTE STAGE - Immediate to 48 hours

R.I.C.E.R.

  • R – Rest. If weight bearing is painful, use crutches
  • I – Ice. Remove shoes and socks and apply ice in a moistened towel to the injury site for 15 to 20 minutes, repeating every 2 hours.
  • C – Compression. Using an elastic bandage. Compress the foot ankle and lower calf.
  • E – Elevate. Ideally it is best to raise to foot higher than the heart.
  • R – Referral. Refer the injured player on to a physiotherapist or doctor.

After the ‘Acute Stage’ treatment involves increasing the range of movement of the joint and regaining strength and co-ordination.

Progression should be gradual using non-weight bearing exercises, partial weight bearing exercises and then to gentle full weight bearing exercises. Movement should then become more functional until light training is possible.

When ligaments are torn, nerve ending which are important to the co-ordination and balance of the ankle joint are also damaged. Balancing exercises are therefore necessary in the definitive treatment.

Together all the exercises aim to increase strength, mobility and co-ordination and will help PREVENT further injury to the joint.

Remember that proprioception (co-ordination) and balance take longer to recover than strength and mobility so balancing exercises should be persisted with for several months.

 
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