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Trigger Point Therapy - Quadriceps

Posted by Judith Winer on

Quadriceps Trigger Points

 

Shortness of the quadriceps can ultimately influence head and neck positioning, cause knee pain, and affect foot and ankle movement.

The quadriceps muscles have a significant impact on pelvic rotation (anterior), kneecap tracking, and knee positioning. Shortness of the quadriceps can ultimately influence head and neck positioning, cause knee pain, and affect foot and ankle movement.

Eccentric contraction decelerates knee flexion, adduction, and internal rotation during heel-strike of the gait cycle. The rectus femoris eccentrically decelerates hip extension and knee flexion during gait. The inter-relationship of all the quadriceps muscles provides dynamic stability to the knee.

 

Quadriceps Trigger Points

 

Trigger Points

Pain involves a deep toothache-like pain (vastus medialis) in the knee joint, or on the lateral or medial aspect of the thigh, including the knee.

Origin

Rectus femoris: Anterior inferior iliac spine (AIIS), and groove above the rim of the acetabulum.

Vastus medialis: Anterior intertrochanteric line, medial lip of the linea aspera, and proximal aspect of the medial supracondylar line. It is interesting to note the attachment into the tendons of the adductor longus and magnus and into the medial intermuscular septum.

Vastus lateralis: Intertrochanteric line and greater trochanter, gluteal tuberosity and lateral lip of the linea aspera, and lateral intermuscular septum.

Vastus intermedius: Anterior lateral surface of the proximal two-thirds of the femur, distal half of the linea aspera, and lateral intermuscular septum.

Articularis genu: Two slips from the anterior femur below the vastus intermedius (pulls the capsule superiorly).

Insertion

All of the quadriceps muscles wrap up the patella (sesamoid bone), with each having a unique and specific line of pull or directional force acting on the patella. They share a common tendon (patellar tendon or ligament) and attach to the tibial tuberosity.

Action

Extend the knee joint. Rectus femoris additionally flexes the hip joint.

Nerve

Femoral nerve L2–L4.

 

Quadriceps Common Trigger Point Sites

Vastus Lateralis - Common Trigger Point Sites and Referred Pain Patterns

 

Indications

Pain/weakness in thigh, “giving way” of knee, night pain, pain on knee extension, post hip fracture/ femoral fracture and splinting, decreased femoropatellar joint “glide,” pain on weight bearing, unexplained knee pain in young, pain/weakness descending stairs (rectus femoris), “toothache pain” near knee joint and “buckling” of knee (vastus medialis/intermedius), patellar tracking issues— chondromalacia patellae (vastus lateralis), jumper’s/runner’s knee, restless leg syndrome, meniscus pain.

Common Causes

Hamstring problems, sport/gym overloading or improper technique (especially skiing, soccer, and squats), poor foot/ankle biomechanics, child/prolonged pressure on the lap.

Differential Diagnosis

IT band syndrome, femoropatellar joint dysfunction, quadriceps expansion injury, tendonitis, lumbar radiculopathy, femoral nerve pathology, knee problems / dysfunction (multipennate).

 

Quadriceps - Trigger Point Therapy Treatment Sites

Quadriceps - Common Trigger Point Sites

 

Trigger Point Therapy Treatment Techniques

Spray and Stretch YES
Dry Needling YES
Wet Needling YES
Compression YES
Muscle Energy YES
Deep Stroking Massage YES
Positional Release YES

 

Self Help and Advice for Patients

Balls, foam rollers, or pressure tools are excellent for quadriceps trigger point issues.

General Advice

Correct lifting techniques. Tubigrip. Avoid prolonged immobility. Home self-stretch. Gait and posture assessment. Avoid heavy “squats” in gym. Moist heat, cold or hot bath, and stretch. Resting periods for cycling. Avoid habitual sitting (i.e. on feet, tucked under). Sleep with pillow between knees.

 

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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell. 

 

 

 

 

 

 


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