Front thigh pain is also known as anterior thigh pain. An acute thigh injury comes on suddenly and includes muscle strains (tears) or contusions which are caused by direct impact or collision. Chronic or gradual onset pain at the front of the thigh occurs over time.
Quadriceps strain (thigh strain)
A thigh strain or quadriceps strain is a tear in one of the quadriceps muscles at the front of the thigh. It can range from mild discomfort to a full-blown tear of most of the muscle, resulting in severe pain and inability to walk. Symptoms typically include:
- Sudden sharp pain at the front of the thigh.
- Swelling.
- Bruising may appear later.
- Strains are graded 1 to 3 depending on how bad the injury is.
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Quadriceps contusion (thigh contusion)
A dead leg, also known as a charley horse is a bruise or contusion caused by a direct impact to the leg, crushing the muscle against the femur (thigh bone) resulting in swelling and sometimes bruising of the thigh muscles.
Symptoms include pain at the time of injury and the athlete is likely to have restricted movement in the muscle. Swelling and later bruising may appear over time. Thigh contusions can range in severity from very mild which is hardly noticeable at the time, to severe injuries where the athlete is unable to walk. Contusions are grade 1, 2 or 3 depending on the severity. It is important the correct diagnosis is made as what may seem like a minor injury can develop more serious complications such as myositis ossificans which is when bone tissue forms within the muscle.
Contusions are either intramuscular or intermuscular depending on whether the bleeding is contained within the muscles surrounding sheath, or whether the sheath is damaged as well. Treatment consists of applying the PRICE principles of protection, rest, ice, compression, and elevation as soon as possible. Rest is essential and heat or massage should not be applied during the acute phase as this may lead to myositis ossificans.
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Myositis Ossificans
Myositis ossificans occur as a complication of not treating a contusion correctly. It involves a small growth of bone within the muscle. Symptoms include:
- Muscle pain, particularly during exercise.
- Restricted range of movement.
- A hard lump may be felt deep in the muscle.
- An X-ray can confirm the diagnosis and show bone growth.
Read more on Myositis Ossificans.
Femur Fracture
A traumatic femur fracture is a serious and usually fairly obvious injury caused by accident or severe impact. The patient will feel severe pain in the thigh. There may be deformity in the thigh, for example, the leg may be at an angle or the injured leg appearing shorter than the other. A considerable amount of swelling may be visible and the patient will be unable to move their leg.
Read more on Femur fracture.
Femur Stress Fracture
The femur bone is the long thigh bone. Prolonged overuse can cause a stress fracture known as a femoral stress fracture. Pain may come on gradually as a dull ache which intensifies if a bending force is applied to the femur. Rest is the key to recovering from this injury.
Read more on Femur stress fracture.
Rectus femoris tendon injuries
These cause pain at the top of the thigh where the tendon of the powerful rectus femoris muscle inserts. Read more on:
- Rectus femoris tendon strain – a tear in the tendon.
- Rectus femoris tendon avulsion – where the tendon tears at the point of attachment pulling a fragment of bone with it.
- Rectus femoris tendon inflammation – gradual onset pain at the point of attachment to the pelvis.
Other muscle strains in the thigh include; Sartorius muscle strain & Gracilis muscle strain
Other causes of anterior thigh pain which should not be missed:
- Slipped capital femoral epiphysis occurs when there is a fracture at the neck or top of the thigh bone. The injury happens to the epiphysis which is where the bone grows as children grow older. It is more common in boys aged 11 to 16 years old and occurs gradually over a period of time.
- Perthes’ disease affects children, most commonly aged between four and eight, but can also occasionally occur in younger children and teenagers. Tiredness and groin pain are two common symptoms, and they may have a noticeable limp. Medical help is needed to diagnose this condition as early as possible to try to prevent and limit any future problems.
- Compartment syndrome
- Tumor
