Orthopedics-Online

Tendonitis of the thigh

introduction

Tendonitis of the thigh often occurs as part of sports injuries or overuse during sports. Another cause can be congenital or acquired malpositions of the thigh, which overstrain the tendons and become painfully inflamed. Much less common causes of tendinitis are rheumatic diseases and bacterial infections of the tendon.
Tendonitis usually heals within a few weeks by taking care of yourself and only doing light exercises to strengthen the muscles. In most cases, anti-inflammatory painkillers are used for therapy, which, among other things, should also ensure that the inflammation does not lead to calcification of the tendons over a long period of time.

definition

Tendinitis (Tendonitis) describes the inflammation of the attachment or original structure of muscles, the tendons. These are used to attach the muscles to bones or other structures. In addition to pure tendinitis, there is also tendovaginitis (inflammation of the tendon sheath), i.e. an inflammation of the tissue canal that surrounds the tendon like a kind of tunnel.

causes

There are different causes of tendinitis in the thigh.
A common possibility is acute or chronic inappropriate strain or irritation of the inflamed tendon. Chronic improper loading can be caused by misalignment of the knee or hip, which means that the tendon is used permanently and in an unphysiological (unnatural) way. Misalignments can exist from birth or arise afterwards through injuries or operations. Of course, unevenly stressful activities such as certain sports (e.g. football) can also be a trigger.

Acute inflammation can result from an injury during exercise, work, or an accident where the tendon is exposed to sudden and strong forces, such as Leap or stumble steps.

Furthermore, inflammation of the thigh tendon should also include rheumatic diseases, i.e. processes in which the body recognizes the tendon tissue as foreign and tries to fight it. In these cases, however, there are usually abnormalities in other parts of the body, such as joint inflammation that is stressed in the morning.

Much less common is an infectious cause - that is, the tendon is infected by bacteria, for example, that have penetrated the surrounding tissue (the tendon sheath) through an open area or injury.

Symptoms

Patients with tendonitis in the thigh complain of pain in the affected area. The pain is usually reported as burning, pulling and stabbing. Often the tendon hurts when the affected muscle is stretched. This can be done deliberately in the form of a stretching exercise or as part of the normal movement process while running. In addition to the pain, there may be less warmth and reddening of the skin over the inflammation. Furthermore, indurations and pressure pain are noticeable. In the case of acute incidents (e.g. tripping steps) it can take up to 24 hours for pain and other symptoms to appear.

In the case of chronic inflammation of the thigh tendons (e.g. due to poor posture), the long-term inflammatory process can lead to calcification of the tendon. This is noticeable by grinding or cracking noises when moving and can be painful. In addition, the long-term protective posture of the thigh (to avoid pain) can lead to movement restrictions when running.

Please also read our topic:

Pain in the thigh

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My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
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Place of inflammation

Inflammation on the inside

Inflammation of the tendons on the inside of the thigh is not uncommon and common in competitive sports. On the inside of the thigh are the adductors, i.e. the muscles that are responsible for allowing the legs to be pulled together towards the middle. These muscles have their origins in the pubic area. The adductor tendons can become inflamed with fast and unfamiliar movements. In footballers and other ball athletes from the performance sector, inflammation of the adductor tendons occurs again and again as a sign of excessive stress, incorrect stress and a lack of regeneration.

The pain that those affected complain about is often load-dependent and occurs when the adductors are used. Since these are also stressed during normal running, it comes to pain even with everyday locomotion. It is important that the muscles and tendons affected are spared if the adductors become inflamed. Treatment with ibuprofen, cold compresses and also with Voltaren® compresses helps acutely. In the course can be treated with heat.

Further information on this:

Pain in the inside of the thigh

Inflammation on the outside

Pain on the outside of the thigh can result from an inflammatory process in the greater trochanter. The greater trochanter is part of the thigh bone and is located near the hip. Tendons of various muscles (gluteal and hip muscles) attach to it. Overloading or incorrect loading can lead to inflammation of the bursa (trochanteric bursitis) on the thigh bone. The bursae have the task of absorbing the pressure from tendons and ligament structures so that they do not rub against the bone. In the case of bursitis, in addition to the bursae, the tendons that lie on these bursae are also inflamed.

The so-called iliotial tract runs over the trochanter. This is a strong tendon ligament that runs across the entire outside of the thigh from the hip to the knee. If the iliotibal tract has to work against strong shear forces due to poor posture or excessive strain (e.g. bow-legged legs), the bursa on the greater trochanter can become inflamed, as the iliotibal tract then rubs along very strongly. This condition is called runner's knee or ITBS.

If the inflammation is caused by misalignments, these must be corrected in order to prevent recurring inflammation caused by the unphysiological (unnatural) stress. If the inflammation is triggered by an acute incident, such as a bruise trauma or improper movement, immobilization, cooling, and treatment with anti-inflammatory drugs is indicated.

Inflammation in the front

The quadriceps muscle sits on the front of the thigh. It is primarily responsible for the extension of the knee.

Patients with hamstring inflammation in the front of the thigh do not always need to be in a lot of pain. There is sometimes talk of a slight stiffness or a feeling of weakness in the quadriceps. If the inflammation is only slight, the symptoms can be reduced by warming up well. If the inflammation is more severe, the pain and problems often get worse over the course of the exercise (e.g. training session).

People who practice sports in which rapid braking, starting and changing direction movements take place (such as tennis, basketball or other sports that involve short sprints) are repeatedly affected.
In principle, however, any sport that involves longer running units, jumping, crouching and short sprints can be the cause. All of these movements involve long, continuous or short, abrupt and intense stress on the quadriceps tendon.

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Front thigh pain

Inflammation in the back

Pain in the back of the thigh can have different causes depending on the location.

Tendonitis in the area of the gluteal muscles often occurs in connection with an inflammation of the bursae in the area of the greater roll hillock (greater trochanter) of the thigh bone. Reasons for this can be a quick tendon or snap hip - a tendon slips or snaps repeatedly over the rolling mound and irritates it or the bursa lying there. This can also inflame the tendons, and in such cases a possible difference in leg length must also be considered.
But here too, excessive exercise can be the cause.

Thigh tendinitis, located roughly in the middle or lower third of the back, affects the tendons of the hamstring muscles. These are the muscles that stretch the hips and bend the knee.
The tendons in this muscle group are shortened in many people. This is because we sit a lot these days and don't walk as much.
The cause can also be poor posture of the leg. However, people who are active in running or who have just started running are often affected.

Please also read our topic:

Back thigh pain

Thigh muscles

Thigh Tie Tensioner -
Muscle tensor fasciae latae
Iliac muscle -
Iliacus muscle
Lumbar muscle -
Psoas major muscle
Comb muscle - M. pectineus
Lean Muscle - M. gracilis
Tailor Muscle - M. sartorius
Hamstring muscle -
Rectus femoris muscle
External hamstring muscle -
Vastus lateralis muscle
Inner thigh muscle -
Vastus medialis muscle
Iliac-tibial tendon -
Iliotibial band
Kneecap - patella
Long Dresser - Adductor longus muscle
Big Dresser - Adductor magnus muscle
Two-headed hamstrings, long head - Biceps femoris muscle, caput longum
Two-headed hamstrings, short head - Biceps femoris muscle, caput breve
Half-tendon muscle - Semitendinosus muscle
Semi-membranous muscle - Semimembranosus muscle
Femur - Femur
Gluteus greater muscle - Gluteus maximus muscle

You can find an overview of all Dr-Gumpert images at: medical illustrations

Inflammation in the knee area

Inflammation of tendons on the knee is not uncommon, especially on the front. This is the tendon of the great knee extensor, the quadriceps muscle. Its tendon can also be subject to long-term degenerative damage, in which case one speaks of tendinosis.
A permanent incorrect load or an acute trauma (e.g. during sport or in the course of a lunge) can be the cause.

In the event of pain in the knee, injuries to the cruciate ligament apparatus, collateral ligaments or menisci should always be considered. This can be ruled out by an orthopedic surgeon. If pain in the hollow of the knee is reported, inflammation of the hamstring tendons - these are the muscles that run along the back of the thigh and attach to the knee - is possible, although this is rare. A doctor's cyst (bulging of the knee capsule in the hollow of the knee) can be ruled out as the cause of the symptoms by a scanning examination by the doctor.

Tendinitis in the groin

The tendinitis in the groin usually manifests itself as pain and swelling, redness and overheating of the affected groin.

The cause of tendinitis is usually an overload, which is why athletes (especially runners) are particularly affected by the disease. In principle, all muscles that pull from the pelvis to the thigh can be affected by tendinitis in the groin, but the hip flexor (Iliopsoas muscle) usually causes the symptoms.

The therapy of tendinitis in the groin consists initially of physical rest, the leg should be elevated. Cooling the groin and taking anti-inflammatory and pain relievers is also useful at the beginning of the disease. During the course, the load should be resumed bit by bit under physiotherapeutic observation.

Quadriceps tendonitis

The quadriceps are the largest muscle in the front of the thighs. At the hip, it helps flex the hips. It causes a stretch on the knee.

The quadriceps tendon is located at the bottom of the quadriceps and runs from there to the kneecap, where it merges with the patellar tendon. Inflammation of the quadriceps tendon is most often caused by chronic overuse of the tendon. The patellar tendon is also often affected by the inflammation, especially in professional groups who work a lot on their knees (e.g. tilers).

The tendinitis is usually noticeable through pain, which increases with exercise. The basic treatment consists in protecting the affected leg and then slowly building up the load.

How long does the inflammation last?

In the case of minor tendinitis, the problem often subsides within a few days with appropriate treatment.

In larger and more heavily loaded muscle groups, such as those found on the thigh, inflammation can last for several weeks and extend even further if not adequately protected and cooled. As a rule, however, it should resolve itself within a few days to a few weeks.
Chronification must be prevented as far as possible. Accordingly, in the event of complaints that last more than a week or in the event of an acute incident, a doctor should be consulted to treat the problem.
Since premature exposure often causes the problem to flare up again, it is important that the closed period discussed with the doctor is observed.

diagnosis

To diagnose thigh tendinitis is the anamnese a central point. By describing the symptoms, as well as their type and the times at which the complaints occurred, the doctor can draw conclusions that help him to make an initial diagnosis or working hypothesis. Furthermore, the clinical examination help to differentiate exactly where in the thigh the problem lies, as it is entirely possible that the pain radiates from another point and is only projected (felt there) by the patient into the described point.

For further diagnostics, the Ultrasound and also the MRI (Magnetic resonance) can be used to visualize the tendons and the surrounding soft tissue. With these methods you can Injuries, cracks and fluid retention (Edema) can be presented or excluded as the cause or consequence of the problems.

If an infectious cause is suspected, possible accumulations of pus (Abscesses) be seen. In addition, if an infection is suspected, a Blood collection carried out in order to check inflammation values in the blood if necessary.
The same applies if one is suspected rheumatic cause. Here so-called rheumatoid factors and various antibody which are the first indications of an ongoing rheumatic inflammation.

In the case of muscular problems in the thigh, other damage should be considered, for example Ruptured muscle fibers and Pulled muscles, be excluded.

therapy

In the case of thigh tendinitis, the causes must be eliminated.
In the case of inflammation caused by accidents, protection and, if necessary, bandaging of the thigh is in the foreground. Treatment with cold packs helps to reduce the swelling and inflammation. If the pain gets worse with cold treatment, it should not be continued.

Painkillers from the class of non-steroidal anti-inflammatory drugs (e.g. ibuprofen, Voltaren®) are used to reduce the inflammation, as these prevent the release of inflammatory messengers. In addition, they also work against the pain.

After initially sparing the affected muscles and tendons, as the inflammation continues to decrease, light movement and stretching exercises should be started. If immobilized for too long, there is a risk that muscles atrophy (recede) and the tendon sheaths stick together. However, this should be discussed with the attending physician, as stressing the inflamed tendons too early can prevent the healing process.

Read also: Home remedies for tendinitis

Taping

Taping is a useful method with which stressed muscles and tendons can be supported.

In the case of tendinitis on the thigh, the elastic kinesiotape is the main one to use. At the beginning of the complaint, taping cannot do much. Rather, the basis of therapy is physical protection. If, however, increasing mobility is possible again, the muscles can be well supported by the tape. As a rule, a physiotherapeutic treatment follows, in which the thigh muscles are to be strengthened again. Here, too, you can initially work with tape.

homeopathy

Homeopathic remedies can also be used for tendinitis. Arnica and Rhus toxicodendron are most suitable to start with.

Bryonia can be used when the symptoms are aggravated by exercise. In addition, remedies such as Symphytum, Lachesis and Sulfur can be taken. Ideally, the homeopathic remedies are used in addition to physical rest and subsequent exercise therapy.