A Rectus femoris tendon strain is a tear of the tendon of the powerful quadriceps muscles at the front of the thigh. It often occurs at its origin at the front of the hip. An avulsion strain occurs when the tendon tears, pulling a small piece of bone away with it.
Rectus femoris tendon strain symptoms
A rectus femoris tendon strain usually occurs whilst doing explosive activities such as running or jumping. Symptoms include:
- Sudden sharp pain at the front of the hip or groin.
- Swelling and bruising may develop over the site of injury.
- It will feel particularly tender when pressing in (palpating) where the tendon attaches at the front of the hip.
- If a complete rupture has occurred then it will be impossible to contract the muscle and a gap or deformity may be visible.
A professional therapist will do a number of specific tests to help diagnose your injury.
Resisted flexion – your doctor or therapist will get you to lift your knee (or leg) up whilst resisting the movement. If pain is triggered then this may indicate a rectus femoris strain.
However, the severity of your symptoms depend on whether the rupture is partial or complete.
What is a Rectus femoris tendon strain?
The rectus femoris muscle is the large quadriceps muscle that runs down the center of the front of the thigh. It is a biaxial muscle meaning it crosses two joints; the hip and knee joints. It is used to straighten the knee (knee extension) or lift the knee up (hip flexion).
As a consequence, there are often very large forces transmitted through this muscle, especially when kicking or jumping.
A partial rupture of muscle can lead to Rectus femoris tendonitis/tendinopathy after the initial rupture has healed. You can avoid groin injuries by ensuring the muscles are strong and flexible through strengthening and stretching exercises.
Rectus femoris avulsion fractures
A rectus femoris avulsion fracture occurs when a strong contraction of the rectus femoris muscle pulls the tendon and a small piece of bone away from the attachment point. Symptoms are the same as a Rectus femoris tendon strain with sudden pain at the front of the hip.
Avulsion fractures of the rectus femoris attachment point occur most often in adolescents. This is because the area is one of the last to fully harden from cartilage to bone, Apophysitis may develop first.
This is an inflammatory reaction to repeated stress on the soft bony attachment.
A rupture of the tendon at the top of the muscle near the hip can be caused by overuse or explosive loads on the muscle like sprint starts or kicking a ball.
This tendon can rupture or become inflamed at the upper part near the origin at the hip. The main cause of this is overuse through kicking or explosive movements as in sprint starts.
Treatment for a Rectus femoris tendon strain
Rest and apply cold therapy and compression immediately. Ice can be applied for 10 to 15 minutes every hour for the first 24 hours or so during the painful acute stage. Frequency can reduce to two or three times a day as symptoms subside.
If the tendon has torn completely then you will need an operation to repair it.
Sports massage after the acute stage can be beneficial. Both cross friction massage applied to the tendon itself, and deep tissue massage to relax the muscles.
A full rehabilitation program of stretching and strengthening exercises should be done before more sports specific functional exercises to return the athlete back to full fitness.
Treatment for avulsion fractures
If an avulsion fracture is suspected, seek medical attention.
Most cases can be treated conservatively, similar to that of a rectus femoris rupture. This consists of rest, ice and anti-inflammatories which may be prescribed by your doctor.
Once pain has subsided, strengthening exercises are recommended to regain full knee and hip strength.
Only those injuries where the bone fragment is separated by 3cm or more from the attachment point require surgery.
Sports Physiotherapist Neal Reynolds explains growing pains in young athletes: