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Rectus Femoris Muscle: Thigh, Knee Pain

The rectus femoris is one of the quadriceps muscles. It is the only quad muscle that crosses and affects the movement of two joints, the hip and the knee. It covers most of the front of the thigh.

Trigger points and muscle strains in the muscle produce different pain patterns. Pain caused by trigger points 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.

Contents of Article
    Rectus Femoris Muscle Showing Location of Trigger Points

    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 It 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 Trigger Points Symptoms:

    Rectus Femoris Referred Pain Pattern

    Rectus femoris trigger points can cause deep aching pain that feels as if it is located under the knee cap
    Other 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 downstairs
    • Restless Leg Syndrome
    • Sharp pain deep in the front of the thigh while sleeping.

    Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice for pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. (Not sold in stores)

    Biofreeze Professional Gel is made for the pain and symptoms of muscle strains. It provides excellent pain relief and may help reduce inflammation caused by a strain and recommended by medical professionals and trainers. 

    What Causes Trigger Points To Develop In The Rectus Femoris?

    The most common cause of rectus femoris trigger points is sitting for long periods. Sitting keeps the muscle shortened, contributing 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 a healthy exercise. However, if you begin walking for exercise and walk too far when out of shape, the rectus femoris will likely 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 due to a stressed rectus femoris. I know you get tired of hearing this, but if you will be walking and standing a lot, wear low-heeled supportive shoes to keep the pain at bay. Save the high heels for special occasions.

    Walking 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 lead to knee pain and stiffness.

    Trigger points also develop after an injury to the muscle or due to muscle imbalances in the 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, get up every hour or so, and move. If you work at a desk, consider investing in a standing desk.
    • 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 muscle capabilities. If your muscles start to feel tired and shaky, stop, and rest. Extreme muscle fatigue leads to muscle strains and trigger point development.

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    The Sparthos Thigh Compression Sleeve provides compression as well as support for the hamstring and quad muscles. It stays in place, it does not slide down, the top doesn’t roll down, and the bottom does not roll up during movement.

    Rectus Femoris Trigger Point Treatment

    Trigger points in the rectus femoris are easily found and easy to treat.  The Trigger Point Therapy Workbook is an excellent resource for learning all about trigger points. It teaches you 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 have training 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.

    Note: The Trigger Point Workbook recommends two tools to treat the rectus femoris.

    The first is Massage Balls. A ball is placed between a wall and the top of the thigh to apply pressure and massage the trigger points. This method works very well.

    The second is the Thera Cane. The Thera Cane is also used to apply pressure and massage trigger points. It is recommended for anyone who may have problems with mobility or balance as it does not require you to lean against a wall. The Thera Cane is highly recommended to treat trigger points throughout the body.

    TWD Recommends

    The Professional Choice Knee Brace is one of the best on the market. Comfortable to wear, and it provides support without binding. The brace helps hold the kneecap in place, stabilizing the joint. It Works well for knee pain attributed to the rectus femoris and other quad muscle trigger points.

    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.

    Interesting facts:

    • The rectus femoris is the largest of the four 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 are 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 pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

    • 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


    Other muscles that should be considered and examined:

    Satellite trigger points associated with the rectus femoris muscle:

    If you find trigger points in the rectus femoris it is likely you will find trigger points in some or all of these muscles:

    • Iliopsoas
    • Vastus Medialis
    • Vastus Intermedius
    • Vastus Lateralis
    • Sartorius

    TWD Recommends

    Doctors and physical therapists often recommend TENS to relax the muscles and ease the pain. The Belifu TENS Unit Muscle Stimulator is highly recommended and a great choice for treating quadriceps and hamstrings muscle pain.

    Rectus Femoris Strain

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

    Muscle strains also occur in the belly of the muscle that covers the middle of the front of the thigh. The pain will be 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. Strains in the lower part of the rectus femoris may cause some soreness and stiffness in the knee. However, you will feel the real pain 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 muscle or tendon fibers affected:

    Grade 1 is a mild strain in which a minimal number of muscle or tendon fibers tear. You will feel a twinge or slight pulling sensation when it happens. Pain is not intense though some will cause discomfort. 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 is often felt, along with instant pain. A Grade 2 strain can affect daily activities because of pain and stiffness. You may limp and find standing from a sitting position painful.

    Grade 3 is a severe strain in which over half of the muscle fibers tear. Pain is immediate and is usually accompanied by a ripping or hard 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 severe injury that should be monitored by a doctor.

    Symptoms of a Rectus Femoris Strain:

    • 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 the 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.

    What Causes Rectus Femoris Strains?

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

    Sports and activities that contribute to rectus femoris strain injury:

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

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    Rectus Femoris Strain Treatments

    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, usually taking 48-72 hours.

    • Protect – Stabilize the muscle and thigh with an Ace bandage or Velcro wrap if a moderate or severe strain.
    • Rest – Rest the leg for 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, use ice packs every 1-2 hours until pain and swelling 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. Use the P.R.I.C.E. protocol 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

    TWD Recommends

    TheraICE Rx Hot & Cold Therapy provides 360 degree cold and warm therapy. The sleeve provides compression, which helps reduce inflammation and pain. An excellent choice for hamstring and quadriceps pain treatments.

    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. It is one of the best supports for high hamstring strains.

    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.

    Tips To Avoid Rectus Femoris Strains

    • Take time for warm-up before sports, exercise and strenuous activities. Warm-ups serve a purpose, it prevents injuries.
    • Pushing past conditioning and fitness levels is when most injuries occur
    • Do not over stretch the muscle.
    • Proper footwear is key to preventing injuries when participating in sports or exercise.
    • Take time off if muscle soreness sets in or you experience an injury. Give the muscle time to heal.

    Muscles with similar pain patterns

    Vastus Medialis
    Vastus Intermedius