At Walker and Hall we know through personal experience how painful and disabling thigh pain in all its forms can be and how it can have an enormous effect on every aspect of your life e.g., washing, shaving, dressing, sitting, standing, walking, driving and working and sports and leisure activities.
It is an area where people frequently have problems and the most common types of thigh pain we treat are
Quadriceps Muscle Strain
Hamstring Muscle Strain
Referred Pain
If your condition is not listed above please contact us
We have extensive experience in treating these conditions and managing your recovery.
To see how Walker and Hall can help you please click on the links below:
Quadriceps Muscle Strain (also known as Quadriceps Tear, Strained Quadriceps Muscle, Torn Quadriceps Muscle, Pulled Quadriceps)
This is one of the most common muscle injuries we treat at Walker and Hall and is characterised by a partial or complete tear of the quadriceps muscle located at the front of the thigh.
Fortunately it responds well to the appropriate physiotherapy treatment.
Anatomy
The quadriceps muscles are the large group of muscles on the front of your thigh. They consist of 4 individual muscles which attach to the pelvis and thigh bone (femur) at the top and insert into the shin bone (tibia) via the knee cap (patella) at the bottom. Individually they are:
- rectus femoris
- vastus medialis
- vastus lateralis
- vastus intermedius
This group of muscles is responsible for straightening the knee during activity and controlling knee and hip movements. The muscles are particularly active during sprinting, jumping, hopping or kicking.
Whenever the quadriceps muscle contracts or is put under stretch, tension is placed through the muscle fibres. When this tension is excessive due to too much repetition or high force, the muscle fibres may be torn. When one or more parts of the muscle tears, the condition is known as a quadriceps strain. In our experience the rectus femoris muscle is the most commonly affected muscle in a quadriceps strain.
Tears to the quadriceps can range from a small partial tear whereby there is minimal pain and minimal loss of function, to a complete rupture whereby there is a sudden episode of severe pain and significant disability. Quadriceps strains range from a Grade 1 to a Grade 3 tear and are classified as follows:
- Grade 1 Quadriceps Tear: a small number of fibres are torn resulting in some pain, but allowing full function.
- Grade 2 Quadriceps Tear: a significant number of fibres are torn with moderate loss of function.
- Grade 3 Quadriceps Tear: all muscle fibres are ruptured resulting in major loss of function.
The majority of quadriceps strains are grade 2 tears.
Causes of a quadriceps muscle strain
- Sudden contraction of the quadriceps muscle which often occurs during sprinting, jumping, hopping or kicking activities and may also be as the result of sudden acceleration e.g., sprinting, in football when a player kicking on the run or performs a long kick or following an inadequate warm-up. As a consequence quadriceps muscle tears are commonly seen in running sports such as football and athletics.
Whilst these are the main causes of a hamstring muscle strain, other factors may predispose you to developing the condition, viz.
- muscle tightness (particularly the quadriceps, hamstrings, gluteals, hip flexors)
- muscle weaknesses (such as the quadriceps or gluteals)
- inappropriate training
- excessive training or activity
- inadequate recovery periods from sport or activity
- inadequate warm up
- joint stiffness (especially the lower back, hip or knee)
- poor biomechanics
- inadequate rehabilitation following a previous quadriceps injury
- decreased fitness
- fatigue
- poor core stability
- muscle imbalances
Signs and symptoms of a quadriceps muscle strain
- Pain – a sudden sharp pain or pulling sensation in the front of the thigh at the time of injury. In minor cases you may be able to continue activity only to have an increase in symptoms on resting later – often the same night or on waking the next morning. In more severe cases you may experience severe pain, muscle spasm, weakness and an inability to continue the activity. If you have sustained a severe quadriceps muscle tear you may also limp or be unable to walk off the playing field.
- You will usually experience an increase in pain during activities which place tension on the quadriceps muscle such as squatting, going up and down stairs, running, jumping, hopping, kicking and performing a quadriceps stretch. It is also common for you to experience pain and stiffness after the aggravating activity with rest and when waking the next morning.
- Swelling pain on firm palpation of the affected area and bruising in the front of the thigh.
- Deformity – this is only seen with a severe muscle tear. However there may be a visible depression in the muscle tissue where the muscle fibres have completely ruptured
How Walker and Hall can help you
A thorough musculoskeletal examination is required to determine the extent of the quadriceps muscle tear and this is essential if the optimum recovery is to be achieved.
Following the diagnosis a treatment plan is devised and discussed with you.
The types of physiotherapy treatment used at Walker and Hall for a quadriceps muscle strain are:
- R-I-C-E – For the first 48 to 72 hours the standard soft tissue treatment of R-I-C-E is used. This involves Resting from aggravating activities, the regular use of Ice, the use of Compression and Elevation
- Pain relieving techniques – electrical therapy e.g., ultrasound and interferential therapy and soft tissue massage to reduce pain and muscle spasm
- Hip and knee spine mobilising techniques e.g., gentle stretching and muscle release techniques
- Home exercise programme – a graduated strength, flexibility, core stability and balance programme to ensure an optimal outcome
- Anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist
Hamstring Strain (also known as Hamstring Tear, Strained Hamstring, Torn Hamstring Muscle, Pulled Hamstring)
This is one of the most common muscle injuries we treat at Walker and Hall and is characterised by a partial or complete tearing of one or more of the hamstring muscles located at the back of the thigh.
Fortunately hamstring strains respond well to the appropriate physiotherapy treatment.
Anatomy
The hamstrings are a group of 3 muscles located at the back of the thigh and are called:
- biceps femoris
- semimembranosus
- semitendinosus
They attach to the pelvis and insert into the top of the lower leg bones. They are responsible for bending the knee and straightening the hip during activities such as running, jumping and kicking.
During contraction of the hamstrings, tension is placed through the muscles. If this tension is excessive due to too much repetition or high force, one or more of the hamstring muscles can tear. This is known as a hamstring strain.
Tears to the hamstring muscles can range from a small partial tear where there is minimal pain and minimal loss of function, to a complete rupture which may require surgery. Like all muscle strains, hamstring strains range from a grade 1 to a grade 3 tear and are classified as follows:
- Grade 1: a small number of fibres are torn resulting in some pain, but allowing full function.
- Grade 2: a significant number of fibres are torn with moderate loss of function.
- Grade 3: all muscle fibres are ruptured resulting in major loss of function.
The majority of hamstrings strains we treat at Walker and Hall are grade 2 tears.
Causes of a hamstring strain
Sudden contraction of the hamstring muscles – this is a common cause of a hamstring strain and mainly occurs when the muscles are in a position of stretch – such as rapid acceleration whilst running or when kicking a long ball in football. They are also seen in sports such as running, hockey and athletics e.g., sprinters, hurdlers and long jumpers.
They tend to occur more frequently in older athletes and particularly following an inadequate warm-up
Whilst these are the main causes of a hamstring muscle strain, other factors may predispose you to developing the condition, viz.
- muscle weakness (particularly the hamstrings or gluteals)
- muscle tightness (particularly the hamstrings, quadriceps and hip flexor muscles)
- inadequate conditioning of the hamstring muscles
- inappropriate training or technique
- excessive training or activity
- inadequate recovery periods from sport or activity
- poor posture
- decreased fitness
- fatigue
- inadequate warm up
- joint stiffness (particularly the lower back, hip and knee)
- poor core stability
- inadequate rehabilitation following a previous hamstring strain
- neural tightness
- muscle imbalances
Signs and symptoms of a hamstring strain
- Pain – you will often feel a sudden sharp pain or pulling sensation in the back of the thigh during the aggravating activity. In minor cases, you may be able to continue the activity only to have an increase in symptoms upon resting later that night or on waking the following morning. In more severe cases, you may be unable to continue the activity and may limp or be unable to walk off the playing field. You may experience an increase in pain during activities which place tension on the hamstring muscles, such as walking, especially uphill, going up and down stairs, running, jumping, kicking and performing a hamstring stretch. It is also common to experience pain and stiffness after the aggravating activity with rest and on waking the next morning
- Swelling, muscle spasm, weakness, pain on firm palpation of the muscle and bruising in the back of the thigh
There are a number of factors which can predispose you to a hamstring strain, a few of these are:
- muscle weakness (particularly the hamstrings or gluteals)
- muscle tightness (particularly the hamstrings, quadriceps and hip flexor muscles)
- inadequate conditioning of the hamstring muscles
- inappropriate training or technique
- excessive training or activity
- inadequate recovery periods from sport or activity
- poor biomechanics
- poor posture
- decreased fitness
- fatigue
- inadequate warm up
- joint stiffness (particularly the lower back, hip and knee)
- poor core stability
- inadequate rehabilitation following a previous hamstring strain
- neural tightness
- muscle imbalances
How Walker and Hall can help you
A thorough musculoskeletal examination is required to determine the extent of the hamstring muscle strain. This is essential if the optimum recovery is to be achieved.
Following the diagnosis a treatment plan is devised and discussed with you.
The types of physiotherapy treatment used at Walker and Hall for a hamstring muscle strain are:
- R-I-C-E – For the first 48 to 72 hours the standard soft tissue treatment of R-I-C-E is used. This involves Resting from aggravating activities, the regular use of Ice, the use of Compression and Elevation
- Pain relieving techniques – electrical therapy e.g., ultrasound and interferential therapy and soft tissue massage to reduce pain and muscle spasm
- Hip and lumbar spine mobilising techniques e.g., gentle stretching and muscle release techniques
- Sciatic nerve mobilising techniques e.g., gentle stretching and muscle release techniques
- Home exercise programme – a graduated strength, flexibility, core stability and balance programme to ensure an optimal outcome
- Anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist
Referred Pain
Not all thigh pain is necessarily coming from the thigh. Occasionally, pain felt in the thigh can be referred or caused by a problem in another area of the body such as the back or spine. This is called referred pain.
What is Referred Pain?
Referred pain occurs when pain is experienced in an area away from the actual injury or problem. This is not uncommon, an example being sciatica, where pain is felt down the leg whilst the problem is in the back, or a heart attack, where the pain is felt in the shoulder, arms and neck.
What structures can refer pain into the thigh?
The following structures have the ability to refer pain into the thigh
- The lumbar and sacral spines (from the 1st lumbar spine to the 2nd sacral vertebra – L1 to S2). Any problems affecting the intervertebral discs, ligaments, nerves and muscles of this area of the spine can mimic a thigh problem
- The hip joint
- The muscles of the hip and pelvis area
How can Walker and Hall help you distinguish between a thigh problem and referred pain
At Walker and Hall you will receive a thorough musculoskeletal examination which will examine all the structures that could possibly be responsible for the thigh symptoms.
It is only following such an accurate examination and diagnosis that a treatment plan can be devised to address your problems.
You will be involved in all stages of your treatment given every opportunity to ask questions.
