Quadriceps Femoris Group

The Quadriceps Femoris Group is located in the anterior thigh and is made up of the Rectus Femoris, Vastus Lateralis, Vastus Medialis, and Vastus Intermedius.

The Quadriceps Femoris Group is frequently referred to as the Quads.

Vastus Intermedius

Anatomical Attachments:

• Origin: Attaches to the anterior and the lateral surface of the proximal femur, the lower ½ of the linea aspera, and the superior part of the lateral supracondylar line.
• Insertion: Attaches to the deep surface of the tendons of the rectus femoris and the other vastus muscles, by the ligamentum patellae into the tibial tuberosity.

Action: Extends the leg at the knee.

Synergist: Rectus femoris, vastus medialis and vastus lateralis.

Antagonist: Gastrocnemius, Popliteus, Gracilis, and Sartorius.

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Nerve Supply: Muscular branches of the femoral nerve (L2, L3 and L4).

Vascular supply: Lateral femoral circumflex artery.

• Primary: The pain refers to the anterior medial thigh with a spillover into the superior and inferior thigh proximal to the knee.
• Satellite or associated triggers: Rectus femoris, vastus lateralis.

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Trigger Point Signs and Symptoms: Difficulty in fully extending the knee after sitting for a long period of time, buckling of the knee and pain in the knee during movement.

Trigger Point Activating and Perpetuating Factors: Mechanical overload of the Vastus Intermedius usually occur secondary, to compensation for TrP development in the other Quadriceps Femoris Muscles.

Differential Diagnosis: Tendinitis, Bursitis, Chondromalacia patellae, Subluxation/dislocation of the knee, Charcot’s arthropathy, Fibromyalgia, Gout, Infectious arthritis, Osteoarthritis, Osteomyelitis, Reiter’s Syndrome, Rheumatoid Arthritis, (Segmental, Subluxation, Somatic dysfunction) L2 L3 or L4 radiculopathy, Bone cancer, Bone fracture, Phantom leg pain with above knee amputation, Degenerative joint disease, articular dysfunction, ACL or PCL sprain or tears, Torn meniscus (cartilage), Patella femoral dysfunction, Sprain/Strain of the thigh or knee, Saphenous nerve entrapment, Iliotibial tract friction syndrome, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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