Diagnosing thigh pain
Have you ever suffered from thigh pain and automatically assumed you must have pulled a muscle in your quadriceps? The thigh is one of those areas that most people think they know, when in fact it can be one of the trickier areas of the musculoskeletal system to pin down a cause for pain. Unfortunately, musculoskeletal physios see all too often patients who have been self treating a “quad strain” or something similar for months when the pain is actually from something completely different. Thankfully, with proper diagnosis from a sports specialist physio most causes of thigh pain are very treatable and unlikely to continue once the source of the pain has been dealt with.
What is the thigh comprised of?
Your thigh region is made up of 3 main groups of muscles:
- The quadriceps (located at the front of your leg)
- The adductors (on the inside area of your leg)
- The hamstrings (at the rear of your leg towards your glutes)
The quadriceps itself is comprised of a grouping of three larger muscles and a smaller muscle that connect just above the knee:
- The Vastus Lateralis (located to the outside of your thigh)
- The Vastus Intermedius (located in the centre of your thigh)
- The Rectus Femoris (smaller and located at the front of the thigh covering the Vastus Intermedius)
- The Vastus Medialis (to the inside of your thigh)
Why can diagnosing thigh pain be difficult?
Thigh pain commonly occurs due to sporting injuries, injuries at work and day to day overuse, but is also a prime culprit for receiving referred pain from other, sometimes not so obvious areas in the body. Due to the thigh’s proximity to the groin, pelvis and role in ITB function, it is common for thigh pain to be referred from those areas, but it is also the prime ground for receiving pain from other conditions such as:
- Sciatica type symptoms – your femoral nerve can refer pain to the front of your thigh
- Hip joint conditions such as arthritis
- Meralgia Paresthetica – when the lateral femoral cutaneous nerve becomes impinged
- Lower back pain
- Vascular problems such as a deep venous thrombosis
- And rarely; a fracture to the femur bone
What is referred pain?
Pain and exactly why we feel it in different parts of the body is a continually evolving science that we don’t know everything about yet. Put simply, referred pain is any pain felt at a location in your body that is not the direct source of the pain. Have you ever visited a physio for a sore shoulder and the first place they started looking at was your neck? That’s referred pain.
It is easy to explain some forms of referred pain due to the direct nature of the way the nerves run throughout the body, but some types of referred pain are more difficult to pinpoint. On the extreme level, amputees have been known to suffer phantom pain in the limb they lost for years following the injury. Things like poor posture, lack of movement and overuse are also associated with referred pain by affecting muscular trigger points.
What are the signs of a thigh strain and how is it treated?
As with most muscular and tendon tears, thigh strains are divided into three grades:
- Grade one – the symptoms of a grade 1 tear may not be present until after the activity is over. It can commonly feel like a thigh cramp with associated tightness and mild pain when the muscles are stretched or contracted.
- Grade two – you will feel immediate pain during stretch and muscle contraction worse than a grade 1 injury and is usually sore to touch.
- Grade three – is a serious injury where the muscle is completely torn. You will feel an immediate burning or stabbing pain in your thigh that will stop you being able to walk without pain and there may even be a large lump of muscle tissue above a depression accompanied by bruising.
As a Sports Specialist Physio we have years of clinical experience diagnosing and treating thigh injuries of all kinds along with diagnosing causes of referred pain to the thigh. After a detailed clinical assessment of your injury, biomechanics, sporting technique and muscle coordination, we will devise a rehabilitation program tailored to your needs.