Category: Lower Limb

  • 24
  • Oct
Quadriceps Tendinitis
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Brief Outline of Quadriceps Tendinitis

Quadriceps Tendonitis

Quadriceps tendinitis, like other versions of tendinitis, involves inflammation of the tendon. This can be a result of repetitive stresses to the quadriceps, or excessive stress before the muscle is conditioned. Pain just above the patella (knee cap), especially when extending the knee, usually accompanies this injury.

Anatomy and physiology

The quadriceps tendon attached to, and covers the patella, becoming the patellar (tendon) ligament below this and attaching to the tibia. The patella runs in the groove of the femur at the knee flexes and extends, which results in the tendon passing over this bone as well. Repetitive stress can cause inflammation of the tendon, especially under contraction, such as when accelerating or decelerating. Minor tears may also occur in the tendon as well when the stress is too much for the tendon to handle.

Cause of Quadriceps Tendinitis Injury

Repetitive stress to the tendon, e.g. running or jumping. Repetitive acceleration and deceleration, e.g. hurdling or football. Untreated injury to the quadriceps.

Signs and symptoms of Quadriceps Tendinitis

Pain just above the patella. Jumping, running, kneeling, or walking down stairs may aggravate the pain.

Complications if left Quadriceps Tendinitis

unattended

The quadriceps muscles may become inflamed, and the tendon will become weak if left untreated. This could lead to a rupture of the tendon. A change in gait or landing form can lead to other injuries as well.

Treatment for Quadriceps Tendinitis

Rehabilitation and prevention for Quadriceps Tendinitis

Rehabilitation should include stretching and strengthening exercises for the quadriceps. Activities such as swimming can be helpful to reduce the stress on the tendon during rehabilitation. Return to a normal activity schedule should be delayed until pain subsides completely and strength is restored. Keeping the quadriceps flexible and strong will help prevent this condition.

Long-term prognosis for Quadriceps Tendinitis

A full recovery with no long-term disability or lingering effects can be expected in most cases of tendinitis, and surgery is only necessary in extremely rare cases.

Orthopaedic Specialist Treating Quadriceps Tendinitis

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

Book Appointment Online for Quadriceps Tendinitis Treatment

  • 24
  • Oct
Iliotibial Band Syndrome
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Brief Outline of Iliotibial Band Syndrome

IlioTibial Band

Iliotibial band syndrome is excessive compression or friction of the iliotibial (IT) band over the greater trochanter at the hip joint, and the lateral condyle at the knee joint. This friction causes inflammation, which can be very painful whenever the knees and hips flex or extend, because it crosses over these bony prominences.

Anatomy and physiology

The iliotibial band is a non-elastic collagen cord stretching from the pelvis to below the knee. It is attached to the iliac crest at the top, blends with the tensor fasciae latae and gluteus maximus muscles, and descends down to attach to Gerdy’s tubercle on the lateral proximal tibia. The deep fibres attach to the linea aspera of the femur on the lateral side of the thigh. The tensor fasciae latae flexes, abduts, and medially rotates the hip joint, and stabilises the knee. If the iliotibial band becomes inflamed due to excessive irritation from the friction crossing over the bone, it will cause pain and tightness, possibly leading to bursitis.

Cause of Iliotibial Band Syndrome

Compression or friction of the iliotibial band. Repetitive hip and knee flexion and extension wihle the tensor fascae latae is contracted, such as with running. Tight tensor fasciae latae and iliotibial band. Muscle imbalances.

Signs and symptoms of Iliotibial Band Syndrome

Knee pain over the lateral condyle. Pain with flexion and extension of the knee.

Complications if left Iliotibial Band Syndrome unattended

The iliotibial band, and accompanying tensor fasciae latae become tight due to the pain and inflammation. If left unattended this can lead to chronic pain and injuries to the knee and/or hip.

Orthopaedic Specialist Treating Iliotibial Band Syndrome

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

Book Appointment Online for Iliotibial Band Syndrome Treatment

  • 24
  • Oct
Thigh Bruise (Contusion)
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Brief Outline of Thigh Bruise or Contusion

A thigh contusion is actually a deep bruise to the muscles of the quadriceps or hamstrings near the femur. The bruising causes pain and limited flexibility in the muscle. High impact sports such as football or hockey are commonly associated with thigh bruising, but any activity that could result in falling on or getting hit in the thigh can cause a contusion.

Anatomy and physiology

The musculature of the thigh includes the quadriceps, comprising: vastus lateralis, vastus medialis, vastus intermedius, and semimembranosus. An impact to any of these muscles squeezes the muscle between the impacting force and the femur. This causes bleeding in the muscle near the femur. This in turn causes the formation of scar tissue that reduces muscle function. The swelling and bruising from the bleeding causes pressure on the surrounding muscle fibres reducing flexibility.

Cause of Thigh Contusion

Impact to the muscle from a blunt surface such as the ground, a helmet, foot etc.

Signs and symptoms of Thigh Bruise (Contusion)

Pain and tenderness over the injured area. Swelling and bruising may be present. Pain with weight bearing and stretching of the muscle.

Complications if left Thigh Bruise (Contusion) unattended

Myositis offificans, which is characterised by the formation of bony deposits or by ossification in the muscle tissue, can develop from unattended thigh contusions. Muscle ruptures can also occur when a contusion is left untreated and activity is continued.

Treatment for Thigh Bruise (Contusion)

Rest and ice. Anti-inflammatory medication. Physiotherapy.

Rehabilitation and treatment for Thigh Bruise (Contusion)

After the pain subsides it is important to regain flexibility and strength in the injured muscle. Gentle stretching will improve flexibility and help to avoid scar tissue formation. While the muscle is healing, working the surrounding muscles as tolerable may help to speed recovery by increasing blood flow and limit scarring. Use of proper protective equipment during activities and avoiding impact to the thigh will help prevent thigh contusions.

Long-term prognosis for Thigh Bruise (Contusion)

Proper treatment of a thigh contusion will ensure that there are no future complications. Flexibility and strength should return to normal after rehabilitation of the injured muscle.

Orthopaedic Specialist Treating Thigh Bruise (Contusion)

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

Book Appointment Online for Thigh Bruise Treatment

  • 24
  • Oct
Hamstring Strain
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Brief Outline of Hamstring Strain

Hamstring Rupture

A hamstring strain, or a pulled hamstring as it is commonly referred to, is a stretch or tear of the hamstring muscles or tendons. This is a very common injury, especially in activities that involve sprinting or explosive accelerations. A common cause of a hamstring strain is a muscle imbalance between the hamstring and quadriceps, with the quadriceps being much stronger.

Anatomy and physiology

The hamstrings are three separate muscles that work together to extend the hip and flex the knee, and correspond to the flexors of the elbow in the upper limb. During running, the hamstrings slow down the leg at the end of its forward swing and prevent the trunk from flexing at the hip joint. The three muscles are the biceps femoris, semitendinosus, and the semimembranosus. Any of the muscles can be strained. Commonly tears or ruptures usually pull away from this attachment as well. Excessive force against the muscles, especially during eccentric contraction (when the muscle is stretching against force), can cause stretching, minor tears, or even a complete rupture.

Cause of Hamstring Strain Injury

Strength imbalance between the hamstrings and quadriceps. Forceful stretching of the muscle, especially during contraction. Excessive overload on the muscle.

Signs and symptoms for Hamstring Strain

Pain and tenderness in the hamstrings; very little in a grade 1, to debilitating in a grade 3. May affect the ability to walk, from causing a limp, to a complete inability to bear weight. Swelling with grades 2 and 3.

Complications if left Hamstring Strain unattended

Pain and tightness in the hamstring will continue to get worse without treatment. The tightness in the hamstring could lead to lower back and hip problems. Untreated strains can continue to progress to a full rupture.

Treatment for Hamstring Strain

Grade 1: Ice, anti-inflammatory medicines

Grade 2 and 3: anti-inflammatory medicines; seek medical help if a complete rupture is suspected or if the patient is unable to walk without aid. Then physiotherapy to promote healing.

Rehabilitation and prevention for Hamstring Strain

Stretching after the initial pain subsides will help speed recovery and prevent future recurrences. Strengthening the hamstrings to balance them with the quadriceps is also important. When re-entering activity, proper warm-up must be stressed and a gradual increase in intensity should be followed.

Long-term prognosis for Hamstring Strain

Hamstring strains that are rehabilitated fully seldom leave any lingering effects. Complete ruptures may require surgery to repair and long-term rehabilitation.

Orthopaedic Specialist Treating Hamstring Strain

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

Book Appointment Online for Hamstring Strain Treatment

  • 24
  • Oct
Quadriceps Strain
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Brief Outline of Quadriceps Strain

Quadriceps Strain

A muscle strain, which is a forceful stretch or tear of the muscle or tendon in a weight bearing muscle such as the quadriceps, is painful and difficult to rest. The quadriceps are involved in supporting the hip and knee structure to hold the body weight. A quadriceps strain can result from a forceful contraction of the quadriceps or unusual stress placed on the muscles. As with other strains it is graded 1 through 3, with 3 being the most severe tear.

Anatomy and physiology

The quadriceps are composed of four muscles; the vastus lateralis, vastus medialis, vastus intermedius, and rectus femoris. A strain may occur in any of these muscles, but the rectus femoris is most commonly strained. Due to the force generated in activities such as sprinting, jumping, and weight training, the musclee may microtear, but when the muscle is stretched forcefully under a load such as with high impact sports like football and hockey, it may also pull away from the attachment or completely tear.

Cause of Quadriceps Strain

Forceful contraction or stretch of the quadriceps.

Signs and symptoms for Quadriceps Strain

Grade 1: Mildly tender and painful, little or no swelling, full muscular strength.

Grade 2: More marked pain and tenderness, moderate swelling and possible bruising, noticeable strength loss.

Grade 3 (full tear): Extreme pain, deformity of the muscle, swelling and discolouration, inability to contract the muscle.

Complications if left Quadriceps Strain unattended

A grade 1 or 2 tear left unattended can continue to tear and become worse. A grade 3 tear left untreated can result in loss of mobility and a severe loss of flexibility in the muscle.

Treatment for Quadriceps Strain

  • Anti-inflammatory medication
  • Immobilisation
  • Physiotherapy

Rehabilitation and prevention for Quadriceps Strain

After the required rest period, activities should be approached cautiously. Avoid activities that cause pain. Stretching and strengthening of the quadriceps will be necessary. Ensuring a balance strength between the quadriceps and hamstrings is important to prevent a strain. Poor warm-up techniques must be observed to prevent strains and gradually increasing intensity will help as well.

Long-term prognosis of Quadriceps Strain

Quadriceps strains seldom result in long-term pain or disability. Surgery is only needed in rare cases where a complete tear does not respond to immobilisation and rest.

Orthopaedic Specialist Treating Quadriceps Strain

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

Book Appointment Online for Quadriceps Strain Treatment

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