Thigh Muscle Strains

A strain happens when a muscle or tendon is stretched or torn. Thigh Muscle Strains¹‚²‚³ most often involve the hamstring and quadriceps muscles because they are important in hip and knee joint function and are used in high-speed sports (running, football, basketball, soccer).³ A tear in the muscle or tendon is susceptible to reinjury.

The hip is the largest ball-and-socket joint in the body and can move in multiple directions. The acetabulum of the pelvis forms the socket, while the femoral head (upper end of femur/thigh bone) creates the ball. There are three sets of thigh muscles:

Hamstring (back of thigh) and quadriceps (front of thigh): Work together to extend and flex the leg.
Adductor (inside of thigh): Pull the legs together (toward the body).

Causes

Forced contraction of a stretched muscle is the most common source of hip/thigh muscle injuries.² Thigh Muscle Strains can be caused by repetitive activities (as in sports) or by an acute injury (fall, overextension, or direct trauma). The risk of a muscle strain increases when there has been a prior injury to the area and muscle tightness (often from failure to warm up properly before activity).

Symptoms

There is often a popping/snapping feeling followed by significant pain when the muscle tears during a Thigh Muscle Strain injury. The affected muscle will usually be painful to touch and frequently include bruising. Swelling and bruising will appear a few days after the injury, commonly lower in the leg and ankle. Other symptoms include swelling, muscle weakness, bruising, and limited range of motion (ROM).

Diagnosing

The diagnostic process includes a physical examination and a complete medical history, emphasizing the events of the injury. During the exam, your physician will test for tenderness and pain during range of motion and stretching to determine the injured muscle/tendon. Diagnostic imaging is not usually necessary, though X-rays may be used to determine if there is an avulsion fracture when the tendon pulls off part of the bone. An MRI can show the severity of a muscle or tendon tear.

Treatments

Treatment of Thigh Muscle Strains often involves avoiding the activity that caused the injury and strengthening the musculature around the injury. Further treatment includes preventative measures to keep the injury from happening again. Proper warm-up and use of protective gear can reduce reinjury risk.

Conservative Treatment Options

Most Thight Muscle Strains can be treated conservatively, even with severe injuries.
Take oral nonsteroidal anti-inflammatory medications (NSAIDs)—such as ibuprofen or naproxen—to reduce inflammation and pain.

The RICE protocol:

Rest: Avoid activities that aggravate the area, including excessive weight-bearing.
Ice: Applying an ice pack immediately after injury helps reduce inflammation. Ice should be applied at most 20 minutes at a time and never directly to the skin.
Compression: Wrapping with a soft bandage or wearing a compression garment can improve swelling and prevent additional swelling.
Elevation: Resting the affected leg above the level of the heart will encourage excess fluid to be reabsorbed by the body, thus reducing swelling.

Heat is most effective at least 72 hours following injury. Usually combined with ice therapy, heat can aid in reducing pain and swelling. Apply heat using a hot bath or heating pad; keep the application no longer than 20 minutes at a time.

Physical Therapy, including home exercises that focus on strength and flexibility of the muscles and tendons involved, can aid in restoring function. Depending on the nature of the injury, a physical therapist may create a personalized exercise program to assist in returning to activity.

Surgical Treatment

When a significant muscle or tendon tear or the tendon is pulled away from the bone (creating an avulsion injury), surgical treatment may be required to repair the tear or reattach the tendon. If you are experiencing significant pain and loss of function following an injury, talk with your orthopedic surgeon about treatment options.

References:

Alaia, MD, FAAOS MJ. Snapping Hip. Ortho Info. Published May 2010. https://orthoinfo.aaos.org/en/diseases–conditions/snapping-hip/
Musick SR, Varacallo M. Snapping Hip Syndrome. Nih.gov. Published April 16, 2019. https://www.ncbi.nlm.nih.gov/books/NBK448200/
Alaia, MD, FAAOS MJ. Hip Strains. Ortho Info. Published July 2020. https://orthoinfo.aaos.org/en/diseases–conditions/hip-strains/