THE CLINIC: Quadriceps Missteps

Thu, 13 Sept. 2012 - 1:43 a.m. MT
Credit: ARA Staff - American Running Association

QUESTION:
Around mile 18 of each marathon I’ve run, I've felt pain in both quadriceps. Is this lactic acid build-up or mini quad pulls? It gets so I need to take walk breaks periodically until the end of the race. How can I prevent this from occurring in the future?
 
Dean Manis
Boulder, CO
 
ANSWER:
You seem to be describing muscular pain, and the fact that it's in both thighs reduces the chance of stress fracture. If the pain is accompanied by tightness or weakness in your quads, they may well be pulled. However, tight hamstring muscles can result in greater strain being placed on the quads, which can lead to muscle-pull symptoms there, especially after running long distances.
 
If you have tight quadriceps, it will be difficult for you to touch your heel to your buttock while lying face-down on the floor and using the hand on the same side as your ankle to pull it in. If tight hamstrings are an issue, lying face up on the floor with one leg bent to your chest, you will have difficulty straightening the knee.
 
There are a multitude of other reasons you could be experiencing this pain. An accurate diagnosis from a sports physician is the first step in avoiding a recurrence.
 
Brian L. Bowyer, MD
Columbus, OH
 
ANSWER:
You may not have pulled your quads so much as taxed them, as many marathoners do, by allowing your form to deteriorate in the late miles of the race. How do photos of you look at the finish? Is your body weight collapsing to the inside of your knee and foot? This posture places less of the load on your gluteals and much more on your quads.
 
To avoid this in the future, you may develop hip extensor and abductor strength with various drills like skipping, bounding, and butt-kicks. When you run, focus on carrying yourself upright over your feet as you move to toe off. Avoid slouching and running "behind your feet." Have a friend observe your form or try videotaping it on a track.
 
John Cianca, MD 
Houston, TX

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(RUNNING & FITNEWS® September / October 2009 • Volume 27, Number 5)



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