Thigh Pain

Quadriceps Contusion

The quads muscles are the main group of muscles in the front of your thigh. A direct blow to these muscles can cause bleeding of blood vessels leading to bruising and swelling and a reduced movement in the knee.

Physiotherapy treatment depends on the severity of the injury. If only mild then physiotherapy can help to control the bleeding and speed up the recovery with advice, massage, compression, ultrasound and taking you through a gradual progressive rehabilitation programme to enable you to return to sport. If more severe a period of rest before physiotherapy starts will be required.

Quadriceps muscle strain

The quadriceps includes 3 muscles and is located in the front of the thigh. The muscles are called vastus lateralis, vastus medialis and the rectus femoris. All 3 can be strained and there are different grades of strain with concern to the severity. A grade I strain means that only a small number of fibers of the muscle are affected and there will be pain felt at that point. A grade II strain means that a significant number of fibers have been torn and there is pain, swelling, reduced strength and movement may be reduced. A grade III strain means that the muscle is completely torn.

Physiotherapy treatment is determined by the grade of the strain. They are able to help with advice, ice, massage, soft tissue techniques, stretching, ultrasound and taping. A graduated progressive exercise programme is advised to regain flexibility and strength of the muscle and enable you to safely return to sport.

Sartorius muscle strain

The Sartorius muscle is long and thin and attaches to the ASIS (anterior superior iliac spine) which is at the top front of the pelvis and runs down and across the front of the thigh to attach to the inside of the main shin bone (tibia). This muscle can be strained.

Physiotherapy can help with advice, ultrasound, massage, taping and setting exercises to regain strength and flexibility of the muscle.

Femoral nerve pain

The femoral nerve is formed from nerve roots exiting the lumbar spine and travels through the pelvis and down the front of the thigh. The nerve can be affected where it exits the lumbar spine or any of the muscles it passes through if become tight can cause compression on the nerve. Also symptoms can arise if the nerve is directly injured ie. by pelvic fracture or if prolonged pressure is applied on the nerve. Symptoms include pain down the front of the thigh and numbness or pins and needles in the thigh. The knee may feel weak and like it will give way and there can be weakness felt in the knee and leg.

Physiotherapy can help by working on any structures that may be affecting the nerve and provide nerve gliding exercises for the nerve itself.

Slipped capital femoral epiphysis

This is a problem with the femur which can cause pain on the inside of the knee. It tends to be more common in boys around the age of 12-15 and being overweight can contribute. The slip of the growth plate over the femur can happen suddenly or more gradually.

Perthes disease

This is a breakdown of bone over the femoral head (top of the thigh bone) which particularly affects males between the age of 4 and 10. Symptoms commonly include a limp and ache in the thigh, groin and knee. Some movement of the hip may be stiff and reduced.

Physiotherapy can help with providing appropriate exercises and advice.

Referred pain

Pain on the outside of the thigh can actually be caused by a problem in another joint such as the hip, back and pelvis. Trigger points in muscles which are not on the front of the thigh can also refer pain there.

Stress fracture of the femur

With overuse a stress fracture of the thigh bone can occur which leads to a deep dull ache in the thigh which is worse if leg hangs over the edge of a bed and pressure applied. If this is suspected then immediate medical referral is required.

Physiotherapy can help to maintain strength in the rest of the body while healing and to restore movement, strength and function in the affected leg once the stress fracture has healed.

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related. We can also recommend a top Singapore pain consultant who can help you.

Other possible cause

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

• cardiovascular symptoms
• respiratory (breathing) symptoms
• gynaecological symptoms
• urinary or genital symptoms
• digestive symptoms
• immune system symptoms
• lymph system symptoms
• hormonal symptoms
• neurological symptoms
• dermatological (skin) symptoms
• medication side-effects
• virus
• infection
• cancer
• disease process
• psychological problem ie. depression, anxiety

Iliotibial band syndrome

The iliotibial band is a large piece of connective tissue that runs down the outside of the thigh and attaches at top to the pelvis and gluteal muscles and at the bottom to the outside of the knee. If there is repetitive bending and straightening of the knee then this can cause pain along the main iliotibial band itself or where it inserts into the knee. There are number of factors that can contribute to the iliotibial band becoming sore and by performing a thorough assessment by a physiotherapist these contributing factors can be determined. Specific exercises have been shown to be useful in treating this condition which can be taught by your physiotherapist. They can also use treatment techniques such as myofascial release and acupuncture to the iliotibial band and related gluteal muscles.

Meralgia Paraesthetica

There is a nerve called the lateral cutaneous nerve of the thigh which supplies the skin of the outside of the thigh. If this nerve is injured or compressed it can lead to pain and feelings of tingling or numbness down the outside thigh. Being overweight, seat belts or trauma can cause an injury to the nerve as it passes over the front of the hip. The pain can be burning and sensitive to heat.

Physiotherapy can help by with advising on anti-inflammatory measures and advise on ways of avoiding things that may be causing compression on the nerve. If physiotherapy is of no help then we can recommend a top Singapore specialist who can carry out further tests to get to the bottom of what is causing your symptoms and advise on other measures that may help.

Slipped capital femoral epiphysis

This is a problem with the femur which can cause pain on the inside of the knee. It tends to be more common in boys around the age of 12-15 and being overweight can contribute. The slip of the growth plate over the femur can happen suddenly or more gradually.

Perthes disease

This is a breakdown of bone over the femoral head (top of the thigh bone) which particularly affects males between the age of 4 and 10. Symptoms commonly include a limp and ache in the thigh, groin and knee. Some movement of the hip may be stiff and reduced.

Physiotherapy can help with providing appropriate exercises and advice.

Referred pain

Pain on the outside of the thigh can actually be caused by a problem in another joint such as the hip, back and pelvis. Trigger points in muscles which are not on the outside of the thigh can also refer pain there.

Stress fracture of the femur

With overuse a stress fracture of the thigh bone can occur which leads to a deep dull ache in the thigh which is worse if leg hangs over the edge of a bed and pressure applied. If this is suspected then immediate medical referral is required.

Physiotherapy can help to maintain strength in the rest of the body while healing and to restore movement, strength and function in the affected leg once the stress fracture has healed.

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related. We can also recommend a top Singapore pain consultant who can help you.

Other possible causes

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

• cardiovascular symptoms
• respiratory (breathing) symptoms
• gynaecological symptoms
• urinary or genital symptoms
• digestive symptoms
• immune system symptoms
• lymph system symptoms
• hormonal symptoms
• neurological symptoms
• dermatological (skin) symptoms
• medication side-effects
• virus
• infection
• cancer
• disease process
• psychological problem ie. depression, anxiety

Adductor muscle strain

The adductor muscles are a group of muscles on the inner thigh which bring your thighs together. There are 3 adductor muscles called the adductor magnus, adductor longus and adductor brevis. All 3 can be strained and there are different grades of strain with concern to the severity. A grade I strain means that only a small number of fibers of the muscle are affected and there will be pain felt at that point. A grade II strain means that a significant number of fibers have been torn and there is pain, swelling, reduced strength and movement may be reduced. A grade III strain means that the muscle is completely torn.

Physiotherapy can help with advice, ice, massage, soft tissue techniques, stretching, working on the back, ultrasound and taping. Exercises can be set to regain flexibility and strength of the muscle and increase general core stability around the pelvis.

Gracilis strain

The gracilis muscle is a very thin muscle that runs down the inside of the thigh. The muscle can be strained and graded as with adductor muscle strain to extent of the injury.

Physiotherapy can help with advice, ice, massage, soft tissue techniques, stretching, working on the back, ultrasound and taping. Exercises can be set to regain flexibility and strength of the muscle.

Obturator nerve injury

The obturator nerve can be injured or be compromised by one of the structures it passes through. If the nerve is affected then pain can arise in the inner thigh and weakness of the adductor muscles that move your thighs towards each other can occur.

Sartorius muscle strain

The Sartorius muscle is long and thin and attaches to the ASIS (anterior superior iliac spine) which is at the top front of the pelvis and runs down and across the front of the thigh to attach to the inside of the main shin bone (tibia). This muscle can be strained and if strained at its lower part near the knee may feel like pain on the inside of the thigh.

Physiotherapy can help with advice, ultrasound, massage, taping and setting exercises to regain strength and flexibility of the muscle.

Femoral nerve pain

The femoral nerve is formed from nerve roots exiting the lumbar spine and travels down the front of the thigh. The nerve can be affected where it exits the lumbar spine or any of the muscles it passes through if become tight can cause compression on the nerve. Also the nerve can be directly injured or causes the symptoms if prolonged pressure is applied on the nerve. Symptoms include pain down the front of the thigh and numbness or pins and needles in the thigh. The knee may feel weak and like it will give way and there can be weakness felt in the knee and leg.

Slipped capital femoral epiphysis

This is a problem with the femur which can cause pain on the inside of the knee. IT tends to be more common in boys around the age of 12-15 and being overweight can contribute. The slip of the growth plate over the femur can happen suddenly or more gradually.

Perthes disease

This is a breakdown of bone over the femoral head (top of the thigh bone) which particularly affects males between the age of 4 and 10. Symptoms commonly include a limp and ache in the thigh, groin and knee. Some movement of the hip may be stiff and reduced.

Physiotherapy can help with providing appropriate exercises and advice.

Referred pain

Pain on the inside of the thigh can actually be caused by a problem in another joint such as the hip, back and pelvis. Trigger points in muscles which are not on the outside of the thigh can also refer pain there.

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related. Also we can recommend top Singapore pain consultants who can help you.

Other possible causes

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

• cardiovascular symptoms
• respiratory (breathing) symptoms
• gynaecological symptoms
• urinary or genital symptoms
• digestive symptoms
• immune system symptoms
• lymph system symptoms
• hormonal symptoms
• neurological symptoms
• dermatological (skin) symptoms
• medication side-effects
• virus
• infection
• cancer
• disease process
• psychological problem ie. depression, anxiety

Hamstring strain

The hamstring muscle has three parts and is located in the back of the thigh. These 3 parts are called the semiteninosis, semimembranosis and the biceps femoris. All 3 can be strained and there are different grades of strain with concern to the severity. A grade I strain means that only a small number of fibers of the muscle are affected and there will be pain felt at that point. A grade II strain means that a significant number of fibers have been torn and there is pain, swelling, reduced strength and movement may be reduced. A grade III strain means that the muscle is completely torn.

Physiotherapy can help with advice, ice, massage, soft tissue techniques, stretching, working on the back, ultrasound and taping. Exercises can be set to regain flexibility and strength of the muscle and return you to sport.

Sciatic nerve pain

The sciatic nerve runs down the back of the thigh and originates from your lower back. Pain can arise from this nerve and feels quite deep and dull. Special tests can be done by your physiotherapist to see if the pain is originating from this nerve.

Physiotherapy can help by working on the lower back, increasing the mobility of the nerve itself and working on any tissues that surround the nerve that may be causing compression or restriction on the nerve.

Referred pain

Pain can be felt down the back of the thigh but the origin of the pain is coming from somewhere else. The pain may be coming from trigger points in muscles in the buttock such as gluteus medius, gluteus minimus and piriformis. Structures in the lumbar spine (lower back) such as the disc, facet joint, muscles and ligaments can cause pain in the back of the thigh. Conditions such as lumbar spondylolisthese and spondylosis can cause back of the thigh pain. Also there can be compression where the nerves exit out of the lower back causing back of the thigh pain. When the pain is referred the symptoms normally start gradually and there may be a feeling of tightness. The symptoms are not normally as severe as when the hamstring muscle is strained and often walking and jogging is painfree.

Physiotherapy can help by carrying out an thorough assessment to work out where the pain in the back of your thigh is coming from. The physiotherapist will then be able to treat the problem appropriately.

Upper hamstring tendinopathy

The hamstring tendon (tendon attaches muscle to bone) which attaches the top of the hamstring muscle to the bone on the bottom of the pelvis can become painful. This tends to be associated with frequent sprinting and tends to be worse when warming up for activity and after activity.

Physiotherapy can help with soft tissue techniques, taping and going through a rehab exercise programme.

Ischial bursitis

The ischium is bone which is at the bottom of the pelvis deep in the buttock. There is a small fluid filled sac known as a bursa which is located between the ischium bone and the hamstring tendon. This bursa can become inflamed and often people complain on pain when they sit on hard surfaces where this piece of bone is under pressure.

Often a referral for having a cortisone injection for the inflammation is required. We can recommend a top Singapore specialist who can carry out this procedure.

Lower hamstring tendinopathy

This is pain in the lowest end of the hamstrings where the tendon attaches to the knee. The pain is often worst when warming up for activity or after activity and is found at the bottom end of the back of the thigh. Happens most often in sports that involve a lot of knee bending ie sprinters.

Physiotherapy can help with advice, icing, soft tissue techniques, taping, acupuncture and setting of appropriate rehabilitation exercises.

Adductor magnus strain

This muscle is one of the muscles on the inner thigh which brings the leg inwards but pain when this muscle is strained can give the mistaken idea that a hamstring strain has occurred. There are 3 different grades of strain as defined under hamstring strain.

Physiotherapy can help to determine with certain tests whether you have strained your adductor muscle or the hamstring. They can then help with advice, icing, soft tissue techniques, stretching, ultrasound and taping. Exercises can be set to regain flexibility and strength of the muscle.

Compartment syndrome

There are several compartments within the body. The compartment at the back of the thigh includes the hamstring muscles and sciatic nerve. With compartment syndrome there is an increased pressure in the compartment with reduced blood flow to the muscles and can lead to pain. When the person tries to exercise the muscles try to expand in size but are unable to do so. People most likely to develop it are endurance athletes and those who have had a history of injury to their hamstrings. The pain is often dull and the leg feels stiff. Cramps and weakness in the back of the thigh can happen during and after training.

Physiotherapy can help determine if this may be the cause of your pain. If present a medical referral will be required. We can recommend a top Singapore consultant to see if this is the case.

Avulsion of the hamstring

This is when the top of the hamstring separates from the bone it is attached to. There will be sudden severe pain. Common ways of this happening are waterskiing and power lifting.

A medical referral is urgently required. We can recommend a top Singapore consultant to see if this is the case.

Vascular pain

The external iliac artery is located on the front and outside of the thigh but when affected there can been pain felt in the back of then thigh. The pain is normally found with cycling and is present when the person exercises and stops when the person stops.

Physiotherapy can assess you to determine if this is the possible cause of your pain. If believed to be the case then a medical referral is required and we can recommend a top Singapore consultant to you.

Stress fracture of the femur

With overuse a stress fracture of the thigh bone can occur which leads a deep dull ache in the thigh which is worse if leg hangs over the edge of a bed and pressure applied. If this is suspected then immediate medical referral is required and we can recommend a top Singapore consultant to you.

Physiotherapy can help to maintain strength in the rest of the body while healing and to restore movement, strength and function in the affected leg once the stress fracture has healed.

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related. We can also recommend top Singapore pain consultants who can help you.

Other possible causes

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

• cardiovascular symptoms
• respiratory (breathing) symptoms
• gynaecological symptoms
• urinary or genital symptoms
• digestive symptoms
• immune system symptoms
• lymph system symptoms
• hormonal symptoms
• neurological symptoms
• dermatological (skin) symptoms
• medication side-effects
• virus
• infection
• cancer
• disease process
• psychological problem ie. depression, anxiety