Front Thigh Pain (Anterior)

Pain at the front of the thigh is also known as anterior thigh pain. Here we explain the common causes, as well as some less common causes of front thigh pain.

Medically reviewed by Dr. Chaminda Goonetilleke, 24th Jan. 2022

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Sudden onset thigh injuries
Gradual onset thigh injuries
Thigh rehabilitation programs

Sudden onset anterior thigh pain

The following injuries occur suddenly. You will most likely know a specific point in time when it occured:

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. Symptoms typically include:

A sudden sharp pain at the front of your thigh.
Swelling may develop depending on how severe your injury is.
Bruising may also appear later.

Read more on Quadriceps/thigh strain
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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 or trauma to your leg. Symptoms include:

Pain at the time of injury.
You may have restricted movement in your leg/muscle.
Your leg may swell up and later bruising may appear.

Femur Fracture

An acute, 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.

Rectus femoris tendon strain/avulsion

These cause pain at the top of the thigh/front of the hip where the tendon of the powerful rectus femoris muscle originates.

It can be difficult to distinguish between a tendon strain and an avulsion injury. Therefore, it is important to seek professional medical advice and imaging.

Read more on Rectus femoris tendon strain.

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Gradual onset anterior thigh pain

The following injuries tend to occur gradually over time through overuse, or from an acute injury which has not healed properly”

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.

Femur Stress Fracture

The femur bone is the long thigh bone. Prolonged overuse can cause a stress fracture known as a femoral stress fracture. Symptoms include:

Pain which develops gradually as a dull ache.
Pain is made worse when a bending force is applied to the femur.

Rectus femoris tendon inflammation/tendinopathy

This causes gradual onset pain at the front of the hip where the Rectus femoris tendon attaches to the pelvis. It may occur through overuse, or follow a tendon strain/rupture which fails to heal properly.

Other causes of anterior thigh pain which should not be missed:

The following injuries and conditions are not particularly common but it is important they are not overlooked if you have pain at the front of the thigh.

Slipped capital femoral epiphysis

The injury happens when the epiphysis (upper end of the bone) where the bone growth plates are located, slips away from the rest of the bone.

It is more common in boys aged 11 to 16 years old and occurs gradually over a period of time.

Perthes’ disease

Perthes’ disease affects children, most commonly aged between four and eight, but can also occasionally occur in younger children and teenagers.

Symptoms includes an ache in the thigh, groin or knee. The patient 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.