Rectus Femoris Strain and Trigger Point Pain Differences

Contents of Article:

Where Is The Rectus Femoris Muscle?

The rectus femoris runs down the front of the thigh¸starting at the hip bone (ilium) down to the knee (patella).

What Movements Does The Rectus Femoris Control?

The rectus femoris straightens the leg at the knee (extension) and raises your bent knee up toward the torso (flexion of the thigh). It helps move the leg forward when you are walking or running.

For detailed anatomy information go to: Rectus Femoris Anatomy: Origin, Insertion, Action, Innervation

Rectus Femoris Muscle Pain

The rectus femoris is one of the quadriceps muscle and the only quad muscle that crosses and affects the movement of two joints, the hip and the knee. The rectus femoris covers most of the front of the thigh. Pain is felt in the front of the thigh, knee, and when strained the hip and the groin. Trigger points and muscles strains in the muscle produce different pain patterns.

If trigger points develop in rectus femoris the pain is in the front of the knee and may extend up into the thigh above the knee.

A muscle strain in the rectus femoris can cause pain anywhere along the length of the muscle, though strains most often occur toward the top of the thigh near the hip and groin.

Rectus Femoris Trigger Points Signs and Symptoms

Rectus femoris trigger points can cause deep aching pain that feels as if it is located under the knee cap. Other signs and symptoms include:

  • Knee pain that feels as if it originates under the knee cap
  • Pain in the front of the knee that may extend up into the lower thigh
  • Weak knee
  • Stiff knee
  • Inability to fully straighten the knee
  • Pain walking down stairs
  • Restless Leg Syndrome
  • Sharp pain deep in the front of the thigh while sleeping
rectus-fem-pn.jpg Rectus Femoris Trigger Point Pain Pattern: Pain in the front of the knee that feels as if it is located under the kneecap. Weakness in the knee is also commonly experienced.

What Activities Contribute To Trigger Points In The Rectus Femoris Muscle?

The most common cause of rectus femoris trigger points is sitting for long periods of time. Sitting keeps the muscle shortened which will contribute to trigger points or small tender points in the muscle. Holding something moderately heavy on your lap such as a child or a large laptop will intensify the problems.

We all know that walking is good for you. However, if you begin walking for exercise and walk too far when out of shape, the rectus femoris is likely to flare up. This is especially true for power walking. And speaking of walking ladies, walking or standing in high heel shoes for hours a day will cause your knees to hurt which is most often attributed to the rectus femoris. I know you get tired of hearing this, but if you are going to be walking and/or standing a lot, wear low heeled supportive shoes to keep pain at bay. Save the high heels for special occasions.

Walking and/or running downstairs or down inclines stresses the rectus femoris which will cause your knees to hurt, be stiff and feel weak.

Other common causes of rectus femoris pain are activities in which you continually bend and straighten at the hip such as cycling, sit-ups and leg lifts. Kicking footballs and soccer balls and swimming using the flutter kick all stress the muscle and can lead to knee pain and stiffness.

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

How To Avoid Development of Trigger Points In The Rectus Femoris

  • Don’t just sit there! Get up walk around, do some simple stretches, jumping jacks, just get up every hour or so and move.
  • Warm up before running, sports and exercise
  • If you are wearing high heels, take them off and walk around barefoot for a while or swap out with flat shoes for part of the day.
  • During exercise do not push past your muscles capabilities. If your muscles start to feel tired and shaky, stop and rest. Extreme muscle fatigue leads to muscle strains and trigger point development.

Rectus Femoris Trigger Point Treatment

Trigger points in the rectus femoris are easily found and easy to treat. If you are interested in learning how to self treat trigger points The Trigger Point Therapy Workbook. is an excellent resource for learning all about trigger points, how to find them, and most importantly how to resolve your issues. If you have patience and are willing to take the time, you can learn how to find and treat muscle trigger points throughout your body.

Many massage therapists, physical therapists, chiropractors, and athletic trainers are trained in trigger point therapy. They can show you how to find and treat specific trigger points that may be troubling you. If you are looking for trigger point therapy be sure to ask about training before making an appointment.

TWD Suggestions For Rectus Femoris 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 warms and 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 Professional’s Choice Knee Support provides more support with adjustable bands. One of the best for people who are on their feet a lot, have buckling knees, or knee arthritis. Highly recommended.

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How Long Before I Feel A Reduction In Pain?

Symptoms often decrease quickly, with noticeable relief in as little as 2-5 days. The key to successful trigger point treatment is consistency and continuing treatment until the trigger points are completely gone.

Other muscles that should be considered and examined in conjunction with the rectus femoris muscle:

Satellite trigger points associated with the rectus femoris muscle:

Interesting facts about the rectus femoris muscle:

  • The rectus femoris is the largest of the 4 quadriceps muscles.
  • Of the four quadriceps muscles, it is the one most often injured.
  • The rectus femoris is responsible for the condition known as ‘knee bugs’. Knee bugs is a creepy crawly type feeling and pain that occurs under the knee cap. This condition is often caused by a trigger point in the rectus femoris muscle.

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

If you have been diagnosed with any of the conditions below the rectus femoris muscle may contribute to the condition or be affected by it. If your pain continues after the injury/diagnoses are healed, you may want to check rectus femoris for trigger points and exceptionally tender areas.

  • Patella femoral dysfunction
  • Floating Patella
  • Subluxation / Dislocation of the knee
  • Buckling knee (trick knee)
  • Anterior Cruciate Ligament sprain or tear
  • Posterior Cruciate Ligament sprain or tear
  • Torn meniscus (cartilage)
  • Quadriceps muscle tear
  • Sprain / Strain of the thigh or knee
  • Iliotibial tract friction syndrome
  • Restless leg syndrome
  • Phantom limb pain
  • L2 L3 or L4 radiculopathy


Rectus Femoris Muscle Strain Pain

A rectus femoris muscle strain most commonly happens in the upper thigh where the muscle attaches to the tendon that to the connects to the hip bone (ilium). The pain is felt in the hip or groin.

Strains may also occur in the belly of the muscle which covers the middle of the front of the thigh causing pain in the middle of the thigh where the muscle strain occurs.

Rectus femoris strains rarely happen in the portion of the muscle above the knee. A strain in the lower part of the muscle may cause some soreness and stiffness in the knee however the real pain will be felt in the area of the muscle strain.

Muscle strains are a result of fibers tearing in the muscle. Muscle strains are graded by the number of fibers affected:

Grade 1 are mild strains in which a minimal number of fibers tear. You will feel a twinge or slight pulling sensation when it happens. Pain is not intense though some discomfort will be felt. Mild strains usually do not affect daily activities.

Grade 2 or moderate strains are tears that affect up to half of the muscle fibers. A tearing or popping sensation may be felt along with instant pain. Moderate strains can affect daily activities because of pain and stiffness. You may limp and find standing from a sitting position painful.

Grade 3 are severe strains in which over half of the muscle fibers are torn. Pain is immediate and is usually accompanied by a ripping or strong popping sensation. If you suspect a Grade 3 strain you should be examined by a physician. A rectus femoris Grade 3 strain rarely requires surgery, but it is a serious injury that should be monitored by a doctor.

Signs and symptoms include:

  • A pulling, tearing, popping or ripping sensation in the muscle.
  • Putting weight on the leg may be painful and cause you to limp. If it is a moderate or severe strain you may not be able to put weight on the leg.
  • The muscle feels tight.
  • The muscle may feel warm to touch.
  • Standing from a sitting position may cause pain.
  • Pain or discomfort when straightening the knee
  • Redness or bruising may develop around the area of the strain.
  • If the strain is a moderate or severe strain swelling may occur.
  • A bump or indentation may be felt where the fiber tears occurred.

TWD Suggestions For Rectus Femoris 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 for 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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Football punters and kickers, soccer players, and sprinters are susceptible to rectus femoris strains.

What Causes A Rectus Femoris Strain Injury?

Sprinters, football kickers and punters, soccer, rugby, and other high contact sports players are susceptible to rectus femoris strains. Any movement in which the thigh is bent at the hip and the knee is extended (think of a high kick of a football or soccer ball) stretches the muscle to its maximum and makes it vulnerable to injury. Rapid acceleration like sprinting can also stress the muscle causing a strain. A hard blow to the front of the thigh can also cause the rectus femoris to tear.

Sports and activities that contribute to vastus medialis injury:

  • Sprinters
  • Football
  • Soccer
  • Rugby
  • Basketball
  • Tennis
  • Hockey

Rectus Femoris Strain Treatment

Rectus femoris strains are common and most can be treated at home.  Starting the P.R.I.C.E. protocol as soon as possible after the injury occurs will help jump-start the healing process and reduce pain and swelling. The protocol should be followed until the swelling and pain decrease which usually takes 48-72 hours.

The P.R.I.C.E. Protocol:
  • Protect – Stabilize the muscle and 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 the 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.

How Long Does It Take A Rectus Femoris Strain To Heal?

  • Mild Grade 1 strains heal quickly usually within 1-3 weeks
  • Moderate Grade 2 stains healing times vary greatly depending on the severity of the strain. Healing time can take 4-12 weeks.
  • Severe Grade 3 strains should be monitored by a physician. Again depending on the severity of the tear in the muscle severe strains can take anywhere from a few months up to a year.

When to see a doctor:

  • Excessive 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

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.

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

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

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

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Sparthos Thigh Compression Sleeves provides support, compression, and warmth to thigh muscles that are sore and stiff.  Buy at Amazon

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.

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Tips To Avoid Rectus Femoris Strains

  • Under conditioning, being out of shape is the top contributor to rectus femoris strains
  • Not taking time to warm up is a huge factor in muscle strains.
  • Not taking recovery days or trying to push past muscle soreness weakens the muscle and increases the likelihood of a strain.
  • Ease into new exercises. Don’t push your muscles past their capabilities.


Donna Martin

Massage Therapist Owner: Twelve years of experience working with clients with chronic pain, post injury pain, and post surgery pain. Muscle dysfunction is often overlooked but can hold the key to many pain conditions.

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