Vastus Intermedius Muscle: Quadriceps Thigh and Knee Pain

Vastus Intermedius Strain and Trigger Point Pain Differences

Contents of Article:

Where Is The Vastus Intermedius Muscle?

The vastus medialis muscle attaches to the thigh bone (femur) below the hip joint and travels down to attach to the knee (patella) and shin bone (tibia).


What Movements Does The Vastus Intermedius Control?

The vastus intermedius straightens the leg at the knee.

For detailed anatomy information:  Vastus Intermedius Muscle Anatomy

Vastus Intermedius Muscle Pain

The vastus intermedius muscle is a deep muscle that lies under the rectus femoris on the front of the thigh. The pain can go as high as the fold of the leg and down to the knee.

Pain caused by a muscle strain can occur anywhere along the muscle which runs from just under the hip joint to the knee.

Trigger point pain tends to concentrate in the middle of the front of the thigh but can radiate up to the fold of the leg as well as descend down to the top of the knee.

Though muscle strain and trigger point pain can be similar, treatment for each is different. It is important to determine if the pain is a strain or trigger points to treat properly.

Vastus Intermedius Trigger Points Signs and Symptoms

Trigger points in the vastus medialis affect the knee and can cause pain to radiate into the inside of the lower thigh. Signs and symptoms include:

  • Pain down the middle of the front of the thigh
  • Pain increases when walking
  • Pain greatly increases when climbing stairs or walking up an incline
  • Problems straightening the knee after sitting
  • Stiffness in the knee causes a limp
Vastus intermedius referred pain pattern Vastus Intermedius Pain Pattern: Pain will tend to localize in the middle of the front of the thigh but can descend down to the knee or go up into the fold of the leg.

What Activities Contribute To Trigger Points In The Vastus Intermedius?

  • Runners and joggers frequently develop TrPs in the muscle due to the repetitive movements
  • Squats and other exercises that require bending and straightening the knee repetitively
  • Sitting for long periods of time
  • The vastus intermedius will develop TrPs if there are trigger points in the rectus femoris, vastus medialis, and vastus lateralis.

Trigger points also develop after an injury to the muscle or muscle imbalances in hips and legs. 

How To Avoid Development of Trigger Points In The Vastus Intermedius Muscle

  • Warm up before running, sports and exercise
  • Stretch upper and lower leg muscles after running and exercise
  • Don’t try and go past your muscles limits when doing squats

Vastus Intermedius Trigger Point Treatment

Many massage therapists, physical therapists, chiropractors, and sports medicine doctors are trained in trigger point therapy. They can show you how to find and treat specific trigger points that may be troubling you.

You can also learn trigger point therapy with the help of The Trigger Point Therapy Workbook. It is one of the best resources to learn how to find and treat your trigger points. It takes time, patience and practice to learn how to find TrPs but once you learn you can you have the skill to self-treat a lot of muscle pain throughout the body. The key to successful trigger point treatment is consistency. Most trigger points respond best to several 1-2 minute treatments a day.

The vastus intermedius muscle lies under the rectus femoris muscle and if you have muscular legs may take a little more pressure from your hands to treat than other muscles. If you have problems with pain in the hands you may want to purchase a Knobble or Thera Cane to use during treatment.

TWD Suggestions For Vastus Intermedius Trigger Points

The Trigger Point Therapy Workbook is the best resource to learn how to treat and manage your muscle pain. Learn the methods and have the knowledge to relieve muscle pain throughout the body.

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Sombra Warm Therapy Pain Relieving Gel is highly recommended for trigger point and chronic pain relief. It relaxes the muscles without the burning heat of other creams. (not sold in stores)

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Rolling the muscle can help treat and reduce muscle pain. If you have limited strength in your arms or hands The Tiger Tail Roller does not require upper body strength like regular foam rollers.

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The ComfiLife Knee Pillow was developed for side sleepers to keep your leg aligned with your hip and spine decreasing your pain while you sleep. Recommended for quadriceps injury and chronic pain sufferers.

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How Long Before I Feel A Reduction In Pain?

You may notice a considerable reduction in pain and stiffness in as little as 2-5 days. For some, there is a noticeable difference after 1-2 treatments. The key is consistency in your treatments and continuing treatment until the trigger point(s) are gone.

Other muscles that should be considered and examined in conjunction with the vastus intermedius muscle:

Satellite trigger points associated with the vastus intermedius muscle:

Interesting facts about the vastus intermedius muscle:

  • The vastus intermedius lies directly under the rectus femoris but each muscle has its own pain pattern. The vastus intermedius pain is deep in the mid-thigh while the rectus femoris pain is toward the lower end of the thigh and with a deep ache in the knee.

Vastus Intermedius Muscle Pain and Symptoms Can Be Similar To, Contribute To, and Be Affected By These Medical diagnoses:

  • Dislocation of the knee
  • Anterior Cruciate Ligament sprain or tear
  • Posterior Cruciate Ligament sprain or tear
  • Torn meniscus
  • Patella femoral dysfunction
  • Chondromalacia patellae
  • Sprain or strain of the thigh
  • Sprain or strain of the knee
  • ACL sprain or tear
  • PCL sprain or tear
  • Iliotibial tract friction syndrome
  • Gout
  • Phantom leg pain with above knee amputation
  • L2 L3 or L4 radiculopathy


Vastus Intermedius Muscle Strain Pain

Because the Vastus intermedius is a deep muscle laying under the rectus femoris, and partially covered by the vastus lateralis and vastus medius, differentiating a strain in this muscle from the other quad muscles can be difficult. The one notable complaint of someone that has a vastus intermedius strain is the pain is deep in thigh near the bone.

Muscles strains are graded by the number of muscle or tendon fibers that are torn.

A Grade I strain is mild and you will feel a twinge or pulling sensation when it happens. Slight bruising and minor swelling may occur. Though it may be uncomfortable the pain is not so intense as to affect most of your daily activities.

With a Grade II or moderate strain, the pain is felt immediately and you may feel a popping or tearing sensation in the muscle. The muscle will feel instantly weak and you will likely limp. Redness along with swelling and bruising may be seen right away or develop over the course of several days. Normal daily activities are affected by pain and muscle weakness.

Grade III strain occurs when the muscle or its tendon tear is across most of the muscle. The most severe is when the muscle or the connecting tendon is ripped in half which is known as a rupture or avulsion. Pain and muscle weakness is instant and the pain is excruciating. Severe strains require medical and care and supervision. Daily activities will difficult for some time.

Signs and symptoms include:

  • Walking and putting weight on the leg is painful. If the strain is moderate or severe you may not be able to put weight on the leg.
  • Tightening the muscles in the thigh causes discomfort and pain
  • The area around the strain may feel warm.
  • Bending and straightening the knee is painful.
  • Redness and bruising develop on the front of the thigh and/or knee.
  • Moderate and severe strains will have swelling around the area where the strain occurred
  • A bump or indentation may be felt where the fiber tears occurred.
Muscle man kneeling

Jobs, sports, exercise, and activities that require repetitive kneeling and standing can contribute to muscle strains and trigger points in the vastus intermedius muscle.

What Causes A Vastus Intermedius Strain Injury?

Vastus intermedius strains usually happen during exercise or sports. Activities that require repetitive bending and straightening the knee can strain the muscle. Contact sports in which the thigh takes a direct blow is stepped or fallen upon can also cause a strain. Quick acceleration of speed, sudden stops and quick changes in direction when running are also contributors.

Sports and activities that contribute to vastus medialis injury:

  • Contact Sports
    • Basketball
    • Football
    • Soccer
    • Hockey
    • Rugby
  • Over-use and Repetitive Motions
    • Running
    • Exercises requiring deep knee bends
    • Walking or running down flights of stairs or steep inclines
    • Overuse of a Stairmaster or elliptical machine
    • Cycling
    • Skiing
    • Gymnastics

Vastus Intermedius Strain Treatment

Vastus intermedius strains are not common and most can be treated at home. Starting the P.R.I.C.E. protocol as soon as possible will help reduce pain, swelling, and start the healing process.

Begin the P.R.I.C.E. protocol as soon as possible:
  • Protect – Stabilize the upper thigh with an Ace bandage or Velcro wrap if the strain is moderate or severe.
  • Rest – Rest the leg the first 24-48 hours. Rest also includes getting extra sleep as the healing process is optimized during sleep.
  • Ice – To reduce swelling and pain you should use ice packs every 1-2 hours until pain and swelling start to decrease. Leave ice in place for 20 minutes per treatment, longer times may damage soft tissues.
  • Compression – Using an Ace bandage or Velcro wrap to apply moderate compression will provide support and discourage swelling.
  • Elevation – Using pillows and blankets to prop up the leg discourages fluids from accumulating around the injury and helps reduce pain and swelling.

Once swelling, heat, and redness have diminished begin alternating cold and heat treatments. Use cold for a 20-minute treatment, then wait 1-2 hours and apply heat for 20 minutes. The P.R.I.C.E. protocol is usually applied for the first 24 – 72 hours after the initial injury.

When to see a doctor:

  • Intolerable pain levels
  • Rapid and excessive swelling and bruising
  • You are not able to move the leg or unable to put weight on the leg
  • Swelling, pain, redness, and heat have not lessened within 24-48 hours

How Long Does It Take A Vastus Intermedius Strain To Heal?

  • Grade I mild strains heal quickly within 1 – 3 weeks.
  • Grade II moderate strains healing time vary depending on the number of fibers torn. Most heal in 4-12 weeks.
  • Grade III severe strains usually require medical attention and can take anywhere from a few months up to a year to heal.

TWD Suggestions For Vastus Intermedius Strains

The Simple Spectra Clay Hot/Cold Wrap can be placed and secured high on the thigh, providing hot or cold treatment as well as compression which is important for recovery. The wrap can also be used on other areas of the body.

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Biofreeze Pain Relieving Gel cools the area much like ice discouraging inflammation. Provides excellent pain relief between cold treatments. Recommended by medical professionals and trainers.

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The Odofit Support Brace has 3 adjustable straps that allow you to adjust the compression to your needs.  The waistband holds the brace in place. One of the best for moderate and severe thigh and groin pain and injury.

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Tips To Avoid Vastus Intermedius Strains

  • Warm up! Taking time to warm up properly can save days, weeks, and months of pain, discomfort, and downtime.
  • If the muscle feels weak, sore, or is injured, take recovery days to rest and allow the muscle time to heal.
  • Ease into exercises that include repetitive bending and straightening of the knee. Don’t push your muscles past their capabilities.

More Pain Relief and Support Suggestions from TWD:

The products listed below are products that I use and highly recommend to my clients and customers. If you regularly work out, run, bike, or hike, and have problems with quadriceps tightness and/or knee pain, these products provide relief and allow you to enjoy your activities.

Penetrex was formulated specifically to reduce inflammation. If you have strained a muscle and have swelling this is the cream to use. Also works well on joint inflammation caused by arthritis. Read and follow directions for best results.

If you are an athlete or exercise aficionado the Freeze Sleeve provides excellent cold compression treatments to quads, hammys, and knees. 

The CW-X Men’s Endurance Pro Tights were made specifically to support quads, hammys, and knees. Highly recommended for runners and cyclists.

The CW-X Women’s Endurance Pro Tights are made for women who participate in activities that stress the hamstrings, quads, and knees. 

The TriggerPoint Roller is excellent for rolling out the quadriceps and hamstrings  A good choice if you are prone to TrPs in the leg muscles.

The Vive Thigh Brace is another choice for adductor support and compression. The brace is adjustable and stays up on the leg well.  Provides warmth for muscle relaxation.

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