The thigh is the area between the pelvis and the knee. We divide the thigh into three compartments: anterior, medial, and posterior.
Anterior compartment muscles
Sartorius: It is the longest muscle in the body. It assists in flexing, weak abduction and lateral rotation of the hip, and knee flexion.
Origin:
anterior superior iliac spine (ASIS)
Insertion:
1. upper medial surface of body of tibia
Pain and symptoms associated with the Sartorius
muscle– Burning stinging pain under the skin starting at the outside of the bottom of the hip, traveling down the thigh to the inside of the knee (pain and/0r stinging can occur anywhere along the muscle)
– Inside of knees may be painful or hypersensitive
– Sleeping with a pillow between the knees often eases pain
Activities that cause sartorius muscle pain and symptoms
– Sitting with legs up and crossed for long periods of time (recliners, sleeping)
– Slipping or a misstep
– Sports that require planting one foot and making a sharp turn (basketball, football)
– Walking with an extended long stride
Quadriceps femoris: It is the knee extensor muscle. As a group, the quadriceps femoris is crucial in walking, running, jumping and squatting. It´s subdivided into four separate “heads”:
Rectus femoris: It is the only muscle of the group which crosses the hip joint and is a powerful knee extensor when the hip is extended but is weak when the hip is flexed.
Origin:
1. anterior head: anterior inferior iliac spine (AIIS)
2. posterior head: ilium just above the acetabulum
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament
Pain and symptoms associated with the Rectus Femoris muscle
– Knee pain that feels as if it originates under the knee cap
– Pain in the front of the thigh extending down into the inside of the knee
– Weak knee
– Stiff knee
– Inability to fully straighten knee
– Pain walking down stairs
– Restless Leg Syndrome
– Sharp pain deep in the front of the thigh while sleeping
Activities that cause rectus femoris pain and symptoms
– Cycling
– Climbing
– Running and power walking
– Swimming
– Kicking a football or soccer ball
– Swimming
– Wearing high heel shoes
– Sitting excessively
Origin:
1. greater trochanter
2. lateral lip of linea aspera
3. lateral intermuscular septum
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament
Pain and symptoms associated with the Vastus Lateralis– Knee pain
– Pain on the side of the thigh extending down into the front and back of the knee
– Pain under the buttock extending toward the hip joint
– Pain occasionally descends into the back of the calf
– Locked knee
– Extended walking increases pain in the thigh and knee
Activities that cause vastuslateralis
pain and symptoms
– Climbing
– Skiing
– Sitting excessively
– Immobilizing the knee ie. casting, inflexible knee brace.
Vastus medialis: It is the deeper muscle of the quadriceps muscle group. The intern is the most difficult to stretch once maximum knee flexion is attained. It can´t be further stretched by hip extension as the rectus femoris can, nor is it accessible to manipulate with massage therapy to stretch.
Origin:
1. intertrochanteric line of femur
2. medial aspect of linea aspera
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament
Pain and symptoms associated with the Vastus Medialis– Pain on the inside of the knee extending half way up the front of the thigh
– Persistent pain in the knee joint
– Can cause the knee to ‘buckle’ (trick knee)
– People often sleep with a pillow between the knees to relieve the pain
Activities that cause vastusmedialis
muscle pain and symptoms
– Deep knee bends
– Running
– Step masters or running stairs
Vastus intermedius: It contributes to correct tracking of the patella.
Origin:
anterior lateral aspect of the femoral shaft
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament
Pain and symptoms associated with the Vastus Intermedius muscle
– Pain down the middle of the front of the thigh
– Pain increases when walking
– Contributes to weak buckling knees
– Pain greatly increases when climbing stairs
– Problems straightening the knee after sitting
– Stiffness in the knee causes a limp
Activities that cause vastusintermedius pain and symptoms
– Climbing
– Running
– Over exercise of the quadriceps muscles
– Overuse of the knee
– Sitting for long periods of time
Medial compartment muscles
Gracilis: Is the most superficial muscle of the medial side. It adducts, medially rotates and flexes the hip, and aids in flexion of the knee.
Origin:
body of pubis & inferior pubic ramus
Insertion:
1. medial surface of proximal tibia, inferior to tibial condyle
Pain and symptoms associated with the Gracilis muscle– Hot stinging pain under the skin on the inside of the thigh
– Pain is constant even at rest, changing position does not subside pain
Activities that cause gracilis muscle pain and symptoms
– Sitting with legs crossed for long periods of time
– Horseback riding
– Skiing
– Slipping or a misstep
– Doing the splits
Pectineus: It is the most anterior adductor of the hip. Its primary function is hip flexion. Also, it adducts and medially rotates the thigh.
Origin:
1. pectineal line of the pubis
2. superior pubic ramus
Insertion:
1. the pectineal line of the femur
2. (just below the lesser trochanter on the posterior aspect of the femur)
Pain and symptoms associated with the Pectineus muscle
– Pain in the fold where the leg joins the body
– Groin pain
– Pelvic pain
– Pain increases when walking
– Sleeping with a pillow between the knees eases the pain
Activities that cause pectineus muscle pain and symptoms
– Sitting with legs up and crossed for long periods of time (recliners, sleeping)
– Slipping or a misstep
– Spreading legs too far apart vertically or horizontally
– Power walking
– Gymnastics
– Splits
– Horseback riding
– Lifting with legs spread too far apart
– Hip replacement surgery
The pectineus is often injured when a person starts a regimen of power walking. During power walking, a person will often extend their stride, reaching farther than they would in a normal stride. Overextension, while walking or running, can stain the pectineus.
The adductor muscle group is used pressing the thighs together to ride a horse, kicking with the inside of the foot in soccer or swimming. They contribute to flexion of the thigh when running or against resistance (squatting, jumping…)
Adductor brevis: immediately deep to the pectineus and adductor longus, the adductor brevis pulls the thigh medially. Also stabilizes the movements of the trunk when standing on both feet,m or to balance when standing on a moving surface. Primarily known as a hip adductor, it also functions as a hip flexor.
Origin:
body & inferior ramus of pubis
Insertion:
superior portion of linea aspera
Pain and symptoms associated with the adductor brevis muscle
– Groin pain during activity, pain subsides with rest
– Pain in the front of the outer upper thigh near the hip joint
– Deep pain in the hip joint
– Stiffness in the hip especially when turning the leg outward
– Pain above the knee
– Pain can descend down into the shin
– Pain increases while carrying objects
– Restricted movement in the hip and thigh
Activities that cause adductor brevis muscle pain and symptoms
– Sitting with legs crossed for long periods of time
– Horseback riding
– Slipping on ice or slick surfaces
– Moving legs too far apart horizontally or vertically
Adductor longus: Adducts the thigh and medially rotate.
Origin:
anterior surface of pubis, just inferior to the pubic tubercle
Insertion:
medial lip of linea aspera on middle half of femur
Pain and symptoms associated with the adductor longus muscle
– Groin pain during activity, pain subsides with rest
– Pain in the front of the outer upper thigh near the hip joint
– Deep pain in the hip joint
– Stiffness in the hip especially when rotating the knee outward
– Pain above the knee
– Pain can descend down into the shin
– Restricted movement in the hip and thigh
– Pain is greater when carrying something
Activities that cause adductor longus muscle pain and symptoms
– Sitting with legs crossed for long periods of time
– Horseback riding
– Slipping on slippery surfaces
– Moving legs too far apart horizontally or vertically
Adductor magnus: Powerful adductor of the thigh made especially active when the legs are moved from a widespread position to one in which the legs parallel each other.
Origin:
1. anterior fibers: inferior pubic ramus
2. oblique fibers: ischial ramus
3. posterior fibers: ischial tuberosity
Insertion:
1. proximal 1/3 of linea aspera
2. adductor tubercle
Pain and symptoms associated with the adductor magnus muscle
– Groin pain during activity, pain lessens at rest
– Pain in the front of the inner upper thigh
– Pain and stiffness in the hip and knee that is often felt throughout the inner thigh
– Deep and or sharp pelvic pain that can affect the vagina, rectum, prostate, and bladder
Trigger points in the adductor magnus can cause pain deep in the pelvic area. Pain may present as a dull ache or a sharp stabbing pain. Those suffering from adductor magnus symptoms often sleep with a pillow in between the knees to ease pain.
Activities that cause adductor magnus muscle pain and symptoms
– Sitting with legs crossed for long periods of time
– Climbing stairs
– Horseback riding
– Skiing
– Slipping on ice
– Moving legs too far apart horizontally or vertically
Posterior compartment muscles
Biceps femoris: It has two parts or “heads”. Both heads perform knee flexión. The long head (1 of the three hamstring muscles) is involved in hip extension. It is a weaker flexor when the hip is extended as well as a weaker hip extender when the knee is flexed. When the knee is semiflexed, the biceps femoris rotates the leg slightly outward.
Origin:
1. long head: ischial tuberosity
2. short head: lateral lip of linea aspera and the lateral intermuscular septum
Insertion:
1. head of fibula
2. maybe to the lateral tibial condyle
Pain and symptoms associated with the biceps femoris muscle– Pain in the back of the knee
– Pain toward the outside of the knee going up the outside of the thigh
– Pain worsens while walking
– Pain in the back of the leg when rising from a sitting position
– Persistent sitting can cause pain in the anterior thigh and deep in the buttock
– Pain when rising from a sitting position
Activities that cause biceps femoris muscle pain and symptoms
– Sitting for long periods of time
– Sitting on a chair with a small seat in which the edge puts pressure on the thigh
– Sitting on a hard surface putting pressure on the hamstrings
– Poorly conditioned athletes frequently injury the hamstrings
– Football
– Soccer
– Swimming
– Cycling
Semimembranosus: It helps to extend the hip joint and flex the knee. Also medially rotates the femur when the hip is extended. It can counteract the forward bending at the hip joint.
Origin:
ischial tuberosity
Insertion:
1. posterior medial aspect of medial tibial condyle
2. fibers join to form most of oblique popliteal ligament (& medial meniscus)
Pain and symptoms associated with the Semimembranosus muscle– Pain just below the buttock
– Pain down the back of the thigh and into the knee, occasionally going into the upper calf
– Pain intensifies while walking
– Deep aching pains in thigh and knee while sleeping
– Deep pain in the back of the thigh when rising from a seated position
Activities that cause semimembranosus muscle pain and symptoms
– Sitting for long periods of time
– Sitting on a hard surface putting pressure on the hamstrings
– Poorly conditioned athletes frequently injury the hamstrings
– Kicking a ball (football, soccer)
– Hurdles
– Doing the splits
Semitendinosus: It lies between the other two muscles. Collectively flex the knee and extend the hip.
Origin:
ischial tuberosity
Insertion:
1. medial aspect of tibial shaft
2. contributes to the pez anserine
Pain and symptoms associated with the Semitendinosus muscle
– Pain just below the buttock
– Pain down the back of the thigh and into the knee, occasionally going into the upper calf
– Pain intensifies while walking
– Aching pain down the back of the thigh while sleeping
– Deep pain when rising from seated position
Activities that cause semitendinosus muscle pain and symptoms
– Sitting for long periods of time
– Sitting on a hard surface putting pressure on the hamstrings
– Poorly conditioned athletes frequently injury the hamstrings
– Kicking a ball (football, soccer)
– Hurdles
– Doing the splits
