The quadriceps muscles are the large muscles at the front of the thigh. There are four of them, hence quad. Because they pass over both the front of the hip joint and also the knee joint, the quadriceps muscle group can act to bend (flex) the hip and also to straighten (extend) the knee. They also have a role as stabilisers of the kneecaps and ensure that they run smoothly in their grooves. The quadriceps’ action allows us to run, jump, walk up stairs and squat down. We use this muscle group almost everyday and need it to be working well in order to perform all of these higher-level activities.
The quadriceps muscles are often targeted in physiotherapy exercises and it is important that they are at full strength after total knee replacement, ACL repair and if the patient suffers with patella-femoral pain or problems. If there is a weakness in this muscle group, then problems can be seen with pain, instability or problem with higher-level functions such as running and stair climbing or jumping.
Movement Range
As this muscle group passes so close to the knee joint and attaches just below it, it can become ‘switched off’ if there is pain or swelling in the area. It only takes as little as 10% swelling within the knee joint (not even visibly noticeable) for the muscle to be inhibited and to stop working well. This may not always be immediately or obviously noticeable, as other muscles can compensate for this. Hip muscles can kick in more and try to help out, and tightness may develop to prevent instability. It takes a careful assessment to identify the weakness, as sometimes it is only in part of the movement range that the weakness is noticed. For example, patients with patella-femoral pain often identify stair climbing as their painful activity, and this pain from the cartilage or the joint can switch off the quadriceps muscles in the middle bending range, which we use for stair climbing. However, when the knee is fully straight, the muscle may work pretty well.
Activating the Muscles
Targeting exercises that work on the specific range of movement where weakness is seen can be very useful. It can also be very useful to use techniques to optimise the activation of the muscle, such as touching the muscle where you wish it to work, and focusing the person’s attention on the part of the muscle you wish to activate most. The message system that works between the brain and the muscle has to be targeted to enable good muscle activity to occur. Another way is to use a piece of equipment called an electrical muscle stimulator (EMS), which sends a small electrical current into the muscle it is placed over – see below. The Compex Muscle Energy Stimulator can be purchased from our online shop. This helps to activate the muscle if it is struggling to switch itself on using touch. A physiotherapist can suggest which types of treatments might work best for your particular problems, and help you to set a plan for re-activating your muscles effectively. The standard ‘off the shelf’ exercises are not always the answer for your particular condition, so if you feel your standard exercises are not working for you, give us a call for an assessment on 020 7884 0374 or email us at info@physiocomestoyou.com.
Adjustable ankle weights can also help to build the strength of the quad muscles as below:
For more information and other exercise examples get in contact.