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.

Rectus Femoris

Anatomical Attachments:

• Origin: There are two heads to the rectus femoris. The straight head attaches from the anterior inferior iliac spine, and the reflected head attaches from the groove on the upper margin of the acetabulum.
• Insertion: Attaches to the upper border of the patella; by the ligamentum patellae into the tibial tuberosity.

Action: Extends the leg and flexes the thigh.

Synergist:

• Prime Movers: Gluteus maximus, Piriformis, Obturator externus and internus, Superior and Inferior gemelli.
• Accessory Movers: Gluteus medius, Sartorius, Iliopsoas, and Biceps femoris (long head).

Antagonist: Gluteus minimus, Tensor fasciae latae.

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Nerve Supply: Femoral nerve (L2, L3, and L4).

Vascular supply: Lateral Femoral circumflex artery.

• Primary: The pain refers to the patella and the lower ½ of the anterior thigh.
• Satellite or associated triggers: Iliopsoas, Vastus Medialis, Vastus Intermedius, Vastus Lateralis and Sartorius.

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Trigger Point Signs and Symptoms: There is a limitation of knee extension, the individual has difficulty in walking down steps, and occasionally the individuals experience sharp shooting pain of the knee cap and the anterior inferior aspect of the thigh during sleep.

Trigger Point Activating and Perpetuating Factors: A fall, persistent sitting with a heavy object on ones lap, surgery of the hip, excessive squats, and walking down several stairs.

Differential Diagnosis: Tendinitis, Bursitis, Chondromalacia patellae, Floating Patella, Knee effusion, Patella fracture, Subluxation/Dislocation of the knee, Buckling knee (trick knee), Charcot’s arthropathy, Gout, Infectious arthritis, Osteoarthritis, Osteomyelitis, Osteoporosis, Reiter’s Syndrome, Rheumatoid Arthritis, (Segmental, Subluxation, Somatic dysfunction) L2 L3 or L4 radiculopathy, Bone cancer, Bone fracture, Phantom limb pain, Degenerative joint disease, ACL or PCL sprain or tears, Torn meniscus (cartilage), Patella femoral dysfunction, Quadriceps muscle tear, Sprain/Strain of the thigh or knee, Saphenous nerve entrapment, Iliotibial tract friction syndrome, Reflex Sympathetic Dystrophy (Complex Regional Pain Syndrome), Fibromyalgia, Systemic lupus erythematosus, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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