Chiropractor Chandler AZ

Pain Radiating Down Thigh to Inner Knee

quadriceps muscle anterior labeled

Pain in any part of the leg is common in all ages. In adolescents, it is often referred to as "growing pains" because the bones are lengthening to their full extent. In older people, leg pain is often the result of an overuse injury or a certain condition. Thigh pain is any type of discomfort felt in the region from the pelvis to the knee. The thigh muscles are an important structural aspect to the body because they aid in leg movement and supporting the body's weight. Most of the time, thigh pain is felt if one of the thigh muscles are strained or pulled. If you are experiencing pain radiating down your thigh to your inner knee, your injury could be more serious than just a pulled muscle.

Most Common Injuries

Adductor longus insertion tendonitis is the damage and swelling of the tissues of the adductor tendon at its attachment to the pelvis. The adductor muscles are commonly known as the groin muscles and are responsible for stabilizing the pelvis and moving the leg toward the midline of the body. Contraction of these muscles places tension on the adductor tendon at its insertion point to the pelvis. Excessive tension due to repetition or high force can cause damage to the tendon. Typically the injury is an overuse injury during activities such as running and kicking. Pain can be felt at the attachment site and down the femur to the inside of the knee. Simple therapy can help reduce the pain and find relief.

knee model patella labeled

Patellar tendonitis is tissue damage and inflammation of the patella tendon causing inner knee pain. The quadriceps muscles at the front of the thigh connects to the knee cap which attaches to the tibia via the patella tendon. The quadriceps muscle is used to straighten and hinge the knee during activities such as running, jumping, and kicking. When the quadriceps are contracted, force is put on the patella tendon and too much force can damage the tendon. Strain from repetitive activities causes the damage to the tendon. It commonly occurs in people who partake in sports with frequent jumping such as basketball.

The quadriceps muscles are made up of the vastus lateralis, vastus medialis, vastus intermedius and the rectus femoris. A strain in any one of these is called a tear. If the tear becomes more severe, it is known as a muscle rupture. Tears commonly occur during activities such as running, jumping, and kicking when a sufficient warm-up wasn't conducted. The most common of the quadriceps muscles to form a tear is the rectus femoris because it is the only muscle to cross both the hip and knee joints. When pain is felt around the knee, there is most likely a tear at musculotendinous junction which is just above the knee where the muscle becomes a tendon.

The vastus medialis is a muscle that forms part of the quadriceps muscles and is located on the outside of the thigh. It attaches to the femur bone right below the hip joint, runs down the outside of the leg and attaches to the patella. Contraction of the vastus medialis is what allows us to extend our knee and straighten our leg. The vastus medialis has a trigger point which can cause thigh and knee pain. The lower end of the vastus medialis is found just on the inside of the knee joint. When this part of the muscle is damaged, it triggers pain to be felt in the inner knee and can extend to the medial thigh. After a few weeks of pain, knee weakness will be noticeable and can actually cause the knee to buckle. An injury to the vastus medialis is common in activities such as running, deep knee bends, and running stairs.

Less Common Injuries

Chondromalacia patella is the softening of the cartilage under the patella, or kneecap. The degeneration of the cartilage is due to the misalignment of the patella as it slides over the femur. The quadriceps muscles pull the patella in a straight line over the femur. When the alignment is off-kilter, it allows for the patella to grind against the femur, causing inflammation and pain. The pain is normally felt in the front of the knee. Chondromalacia patella is one of the most common causes for chronic knee pain. This condition is most common among females, people who are knee-knocked, runners who are flat-footed, and people who are predisposed to an unusually shaped patella.

knee model lateral view labeled

The Medial Collateral Ligament (MCL) is a large ligament on the inside of the knee that connects the femur and the tibia. Ligaments are responsible for holding bones together and adding stability and strength to joints. An injury to the MCL is referred to as an MCL sprain. The injury is either a stretch to the ligament or a tear. An MCL sprain is most often caused by a blow to the knee and often happens in contact sports. Depending on the severity of the tear, the pain can be referred to the thigh.

An injury to the medial meniscus is common to an MCL sprain. The medial meniscus is a band of cartilage attached to the tibia that goes around the knee joint and is located between the medial condyles of the tibia and the femur. It's purpose is to stabilize the knee during flexion, extension, and circular motions. Like an injury to the MCL, the most common injury to the medial meniscus is a tear. Swelling and severe pain can be felt on the inside of the knee and up the thigh. An injury to the medial meniscus happens when the knee is twisted or sprained with sudden force.

Most common and less common injuries to the knee can all be treated with conservative treatments to avoid surgery.

Home Treatments

At home the first step is always PRICE: protect, rest, ice, compress, and elevate. Reduce the stress and strain to the knee. Over the counter nonsteroidal anti inflammatory drugs (NSAIDs) as recommended by your doctor can help reduce pain and inflammation. Ice helps block the knee pain and reduce inflammation.

Medical Treatments

NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options, as well. Pain management is not usually required unless stronger medications or joint injections are involved in treatment.

MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. Nerve conduction velocity (NCV) testing may be utilized in cases that also involve muscle, sensory or reflex loss.

Conservative Treatments

GT therapy

Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.

Iliotibial band Syndrome is common in runners who develop the injury because of weakness and poor stabilization of the leg and hip muscles. Specific knee exercises are given to increase strength and endurance. Proprioception exercises help teach the muscles how to work together again to stabilize the knee during walking or running.

tissue progression sm

When these treatments are incorporated into a treatment plan, patients heal faster and are less likely to have long-term pain, soft tissue fibrosis, or scar tissue in the injured muscle. These soft tissue treatments are incorporated with therapeutic exercise and flexibility programs.

Improve Movements to Eliminate Hip Pain

The back, hip, and lower extremity work as a comprehensive unit allowing for many of the repetitive tasks you complete at home, work, and during recreational activities. Injuries to one area of the musculature often indicates that additional damage has been incurred by adjacent muscles.

Many therapeutic exercises can help restore proper strength and endurance to the leg muscles. Isometric exercises are often the initial treatment exercises, followed by single plane rubber band exercises for the hip, knee, and ankle: flexion, extension, adduction, abduction, circumduction, inversion, and eversion. Dynamic exercises involving stability foam, rubber discs, exercise ball, and BOSU balls can be performed on the floor. The more unstable the surface, the more effort and stabilization is required of all the lower extremity muscles.

Vibration plates enhance neuromuscular learning throughout the ankle, knee, foot, hip, and back muscles. Additional strength exercises can be found on the hip, knee, and foot strengthening pages. More information for injuries and treatments for knee pain and foot pain.

Our Chandler Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.