Quad Strain Rehab: Phase ZERO / 48hrs Post

This is the second post in this rehab series. This is not meant to be instructional or prescriptive. This is simply me documenting how I am thinking through the earliest phase of rehab and what I am learning in real time.

Right now, I am about 48 hours post injury and firmly in what I am calling Phase Zero.

For me, Phase Zero ends when normal gait returns. That is the only marker that matters right now. Until I am walking normally, everything else is secondary. (see the attached video of my current gait pattern)

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(1) PHASE ZERO INTENT

The intention of Phase Zero is simple.

Reduce guarding.

Restore circulation.

Maintain movement patterns.

Gather information.

With this phase, I'm not trying to drive adaptation. I am trying to understand what ranges, patterns, and positions are currently available so I can build a plan around my current reality.

At this point, I can barely walk due to a lack of hip extension. That keeps me squarely in Phase Zero.

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(2) CURRENT TREATMENT MODALITIES

These are the modalities I am using right now.

• Red light therapy as the primary modality

• Compression boots used post workout to control swelling

• Tight compression wrap worn throughout the day

• Compression recovery tights worn overnight (until my quad sleeve arrives)

The goal here is simple. Reduce background inflammation and stabilize the tissue while I explore movement options.

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(3) MORNING SESSION | BLOOD FLOW AND PATTERN EXPOSURE

The morning session was intentionally unstructured. The goal was blood flow and pattern exposure, not training.

I went into the gym and tested equipment to see what I could tolerate without pain or compensation.

What I learned:

• I can ski with near normal mechanics

• I can ride the bike if the seat is slightly higher and I stay in a forward position

• Battle ropes feel safe and effective

• Hip extension is the main limiter for movements - and is creating some lower back fatigue / compensation

What I did:

2 rounds

• 3 min ski

• 3 min bike erg

• 3 min battle ropes

• 3 min bike erg

Total time: 24 minutes

I finished with band resisted jog in place work at a metronome of 175 strides per minute. The goal was maintaining rhythm and coordination inside whatever ranges were available.

This entire session was about circulation and staying connected to familiar movement patterns.

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(4) AFTERNOON SESSION PART ONE | EXPLORING TRAINABLE OPTIONS

The first block of the afternoon session was meant to explore trainable options. I kept it very basic.

The goal was proving to myself what patterns are currently available in partial ranges.

Structure:

• 4 rounds

• 10 reps per movement

A) Box squats to 18" box - pain = 0-1/10

• Progressed from bodyweight with hand assist --> 45#

• Used a sit rock drive style

• Tempo roughly 3 seconds eccentric, 2-3 concentric

B) Kettlebell deadlifts, Elevated 6-7" - pain = 0/10

• Progressed 35-->53#

NOTE: I could not get to the floor with lighter kettlebells, but I suspect a barbell may be workable sooner due to starting height. I will start with high-handle trap-bar DL tomorrow.

C) Box step ups @ 12" box - pain = 0-1/10

• Unloaded, Russian step up style

• Leg kept in front to avoid hip extension

This block confirmed I can squat, hinge, and use single leg patterns in partial ranges without aggravation.

**No upper body work today.

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(5) AFTERNOON SESSION PART TWO | RANGE OF MOTION FINDING

The second block was dedicated to range of motion finding.

The biggest limiter right now is hip extension, especially when the knee is bent. That lines up with a rectus femoris strain.

The goal here was to expose hip extension gradually while keeping pain very low.

Structure:

• Low-pain ROM work for the hip & quad

• 3 sets each movement

A) Forward and backward bear crawl - pain = 0-1/10

• Alternating hip flexion and extension

• Stayed inside a very tolerable range

B) Long stance glute bridge iso with opposite hip flexion - pain = 2-3/10

• Knee angle roughly 30–45 degrees

• More knee flexion increased pain in hip extension

• Iso holds with opposite hip flexed

• 2 sets of 10-second holds per side per round

*VIDEO ATTACHED

C) Quadruped knee extension - pain = 0/10

• Knee flexion without added hip extension

• Focused on quad activity and neural drive on the injured side

Nothing in this block exceeded a 2–3/10 pain level.

My test-retest is always gait. After this block, gait was still far from normal, but clearly moving in the right direction.

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(6) REHAB WORK | DIRECT TISSUE LOADING

The final block of the session was dedicated to direct rehab work for the rectus femoris.

The goal here was controlled isometric loading of the injured tissue in positions that matter for gait, squatting, and running, while keeping pain low and predictable.

Structure:

• Isometric holds

• 3 sets per position

• 20 seconds per hold

A) Seated straight leg extension iso (180° knee extension) - pain = 1-2/10 (3# ankle weight)

• Seated upright = Hip flexion with full knee extension

• 3 lb ankle weight

• This was close to the maximum tolerable load in this position

B) Seated knee extension iso @ ~110-120° knee flexion - pain = 1-2/10 (3# ankle weight)

• Same upright seated position

• Different muscle length for the rectus femoris

C) Thomas test style iso hold - pain = 3/10 (3# ankle weight)

• Supine on bench

• Opposite knee hugged to chest

• Injured leg dropped into hip extension with knee flexion

• Most direct loading of the injured tissue

*VIDEO ATTACHED

D) Split squat iso holds (band assisted) – pain = 1–2/10

• High position with shallow split

• Depth limited to tolerable range

• Assisted with green Rogue band as needed

• 3 sets of 20-second holds per leg

This block gave me the clearest signal of what the tissue will tolerate right now. These isometric positions will be the primary rehab tool, with progression coming through load, time under tension, and range of motion.

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(7) END OF DAY TAKEAWAYS

By the end of the session, gait was improved compared to pre-session in the day. It is still not normal, which tells me we stay here with some really basic exercises.

I now have:

• A list of positions I can load

• A clear set of limitations to respect

• Variables I can progress over time including load, time under tension, and range of motion

For the next few days, I will stay with a very similar exercise menu and look for gradual improvements in gait, tolerance, and available range.

Phase One begins when gait returns to normal.

More to come.

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