TRIGGER POINT OF THE WEEK – QUADRICEPS RECTUS FEMORIS
One quadriceps muscle alone takes its origin from the Anterior inferior aspect of the Ilium(AIIS) just above the hip socket – this is the Rectus Femoris; this makes the Rectus Femoris the main hip flexor in the body. Hip flexion can also come from the Psoas major, minor and the Iliacus however these are considered weak hip flexors in comparison.
The Rectus Femoris also extends the knee as it crosses two joint lines, it really is the workhorse for hip flexion and knee extension, when you consider it, we use this muscle in walking or running and even when sitting so it is under a lot of load. Trigger points in the Rectus Femoris often present as pain/weakness in thigh, “giving way” of knee, night pain and pain on knee extension. Trigger point pain for the Rectus Femoris muscle tends to manifest around the patella itself and in a line along the front of the thigh.
The quadriceps muscles have a significant impact on pelvic rotation (anterior), kneecap tracking, and knee positioning. Shortening of the quadriceps can influence both hip and knee function having an impact on the posture. We recently saw a case of a 14-year-old male soccer player who got kneed in the thigh during a game one month previously; he saw other therapists but no-on was able to help it. He presented with a loss of full flexion and extension of the knee as a result of antagonistic muscle hypervigilance. We treated the hamstrings first with deep stroking massage then worked on the rectus femoris trigger point just above the hip joint with 5-10 minutes of Inhibition/Ischemic compression. The boy made a full recovery in two sessions.
How do you treat trigger these trigger points? We’d be delighted if you want to share your own best practice.