Thigh (Quadriceps / Hamstrings) Pain
The quadriceps are a large group of muscles on the front of the thigh which work to bend the hip and straighten the knee. The hamstrings are a group of 3 muscles on the back of the thigh which extend the hip and bend the knee. Quadriceps are more prone to direct contact injuries than the hamstrings, however, the hamstrings are more prone to muscular tears.
Muscular tears
Can arise in both muscle groups and are accompanied by bruising, weakness and a loss of range of motion due to pain. Hamstring muscle tears can be contractile (during sprinting) or tensile (when you slip, and the hip bend and knee straightens quickly). Quadriceps muscle strains and tears are due to contractile forces. Initial treatment is reduction of swelling and pain, and gradual restoration of range of motion. Hands on treatment of scar tissue prior to a graded strengthening program ensures the muscles are not hindered by adhesions or prone to further tears.
Muscular contusions
This is more common in the quadriceps and is when a hard object strikes the muscle causing damage deep within the muscle. This swelling and bruising leads to difficulty activating the muscle and stretching. Immediate management is stretching and ice to decrease the amount swelling within the muscle. Following this hands-on swelling management is useful to ensure that the bruising does not cause any further damage within the muscle. Return to sport will be graded dependant on the amount of swelling and restriction. This condition often does not cause any long-term concern, however at times can.
Myositis Ossificans
This term refers to a subsequent injury following something like a contusion. Sometimes chronic bruising can lead to calcification and bony deposits within the bruised structure. Initial medication is used to decrease bruising and inflammation following by a structured stretching and return to activity program supervised by your physiotherapist.
Tendinopathy
Quadriceps tendinopathy affects the quadriceps tendon above the patella, with hamstring affecting the proximal tendon under the bottom or tendons at the back of the knee. Both tendinopathy variations require a graded strengthening program and assessment to reduce any biomechanical alterations predisposing the tendons to chronic overload.
Iliotibial band (ITB) syndrome
The ITB is a band of non-tensile (does not stretch) fascia which has thickened and provided a connection for surrounding muscle to the outside of the knee. The ITB is highly innervated by nerves, and when it has reached is maximum amount of tensile load can cause burning and pins and needles over the ITB. This is worsened with activity and eases with rest. Treatment focuses on decreasing tension applied to the ITB by releasing the muscles which attach to the ITB and correcting any muscle imbalances in your hip or thigh that might have lead to the ITB syndrome occuring.
Contact Free Movement Physio to book an appointment for a one on one consultation to discuss your thigh concerns.