Do your quads hurt when you run? Your injury might be more serious than you think.

Most of the time, a little soreness in the front of the thighs is no cause for concern. If you’ve recently changed up your training, your quads may experience delayed onset muscle soreness (DOMS). But if quad pain is a regular symptom for you, your pain comes on suddenly or you feel pain even when you’re not running, you could have a more serious injury.

Quad strains and femoral stress fractures both cause pain at the front of the thigh, and both are common among runners, says Kevin Maggs, D.C., director of The Running Clinic and a chiropractor in Gainesville, Va. Here, Maggs shares advice for keeping your quads happy and addressing issues if they do arise.

Prevent Quad Pain Before It Strikes

Training errors are the biggest risk factor for any running injury, Maggs says. If you increase hill work, speed and/or distance too quickly, your body doesn’t have a chance to adapt to the increased demands. For this reason, following a measured and patient training plan is one of the most important things you can do to stay injury free.

A dramatic increase in speed work directly affects the workload of the quads. “As you increase speed, you decrease the range of motion at your ankle and increase range of motion at your hip and knee,” Maggs says. “When this happens, there is more knee flexion and more hip extension, both of which place more strain at the rectus femoris muscle [longest quad muscle] during the swing phase of your gait.”

Landing too far out in front of your center of mass also places more strain on your quads. Increasing your cadence (number of steps per minute) can help limit overstriding and reduce the load to your quads.

Get A Professional Diagnosis

“While runners traditionally think they have a quad strain, I wouldn’t be exaggerating if I said that 50 percent of runners who’ve come to see me with quad pain had femoral stress fractures,” Maggs says. For this reason, he highly stresses the importance of getting a professional diagnosis when quad pain persists.

Quad strains tend to present as acute pain in a specific part of the muscle. Pain may improve as you start running but then feel worse afterward. A femoral stress fracture feels like poorly localized, deep pain in the thigh. The pain typically worsens as you run and can be present even when your quads are not bearing any weight.

If you’re experiencing minor quad pain during and between runs, it’s possible your body is just adapting to your training. However, Maggs still recommends addressing symptoms before they become something bigger. You may need to take additional recovery days between runs or cut back on speedwork until your pain resolves.

Aim For An Active Recovery

If you’ve injured a quadriceps muscle, it’s important to allow time for recovery while also continuing to load the injured tissue. “If you completely take time off, the capacity of the tissue decreases, and when you do go back to running, you’re even more vulnerable to injury if you go back to your previous mileage too quickly,” Maggs says.

He recommends lower-body strength training with short range-of-motion loading, practicing exercises such as squats and leg presses with light loads and decreased ranges of motion as necessary. Maintain your cardiovascular fitness through modalities such as cycling or swimming (you can put a pull buoy between your legs if necessary).

Again, don’t try to diagnose and treat quad pain on your own. An expert who specializes in running injuries can help you identify your unique injury and guide you toward recovery.

Optimize Your Cadence

Your cadence or stride rate per minute helps indicate whether you are landing under your center of mass or reaching your legs too far out in front of your body. The slower your cadence, the more likely you are overstriding and the greater the load you place on your hips and knees. Studies have shown that a cadence of at least 180 is optimal for injury prevention.

To determine your cadence, first start running. Once you get to a comfortable pace, set a timer on your watch or phone for 30 seconds and count how many times your right foot hits the ground. Multiply this number by four to find your cadence. The number should be somewhere between 140 and 200. If you find that you’re below 180, aim to gradually increase your cadence by about 5 percent at a time.