Anatomy: The femur is the only bone in the thigh. Innumerable muscles are attached to the bone.

Symptoms: Pain and tired sensation in the thigh. The pain is aggravated upon applying pressure (direct and indirect tenderness) and applying load (walking, running).

Examination: X-ray. Since many stress fractures are not visible early in the course, x-ray examination can be repeated after a few weeks, if stress fractures are still suspected. Scintigraphy, CT, MRI and ultrasound scans can often diagnose stress fractures far earlier than x-rays (Ultrasonic image). The frequency of stress fractures in the femur is probably more often than presumed (article). It is crucial for the result of the treatment that the diagnosis is made as early as possible (article).

Treatment: The treatment primarily comprises relief. Only in special cases is surgery necessary (article).

Rehabilitation: The rehabilitation is completely dependant on the type of fracture and the treatment (relief or surgical). A rehabilitation period of 2-4 months must be expected before maximum participation in sports activity can be resumed (article).

Complications: If progress is not smooth, you should be medically re-evaluated to ensure that the fracture is healing according to plan. In some cases a false joint is formed (pseudoarthrosis), which requires surgical treatment.

Anatomy: The thigh muscles are dealt up in three muscle groups (muscle compartments) of powerful, partially unyielding, muscle membranes (fascias): a front, an inner and a rear muscle compartment. The anterior thigh muscle consists of four muscles (M vastus lateralis, M vastus medialis, M rectus femoris and the deep lying M vastus intermedius).

Symptoms: Pain and swelling in the muscle. In some cases a hard, tender accumulation can be felt (accumulated bleeding in the muscle), in other cases a bluish discoloration of the subcutis (the bleeding has penetrated the muscle membrane and spread into the sub cutis). The pain is aggravated upon activation and stretching of the muscle.

Acute treatment: Click here.

Examination: In slight cases with only minimal tenderness and no discomfort when walking, medical examination is not necessarily required. The severity of the tenderness is, however, not always a measure of the extent of the injury. In cases of more pronounced tenderness or pain, medical examination is required to ensure the diagnosis and treatment. The diagnosis is usually made following normal medical examination, however, if there is any doubt concerning the diagnosis, ultrasound scanning can be performed, as this is the most suitable examination to ensure the diagnosis (Ultrasonic image). The larger the bleeding as assessed by ultrasound scanning, the longer the period needed to heal the injury.

Treatment: The treatment primarily consists of relief and rehabilitation as with muscle rupture in the anterior thigh. In cases of large accumulated bleeding the blood accumulation can be drained under ultrasound guidance. If the bleeding is located medial (M vastus mediale) or lateral on the thigh (M vastus lateralis), the rehabilitation will usually go more quickly. If the bleeding is located in the centre of the front thigh muscle (M vastus intermedius or M rectus femoris), a longer period of rehabilitation must be expected as sudden jumping or kicking will comprise a risk of a muscle rupture in the damaged anterior thigh muscle. Some recommend treatment with rheumatic medicine (NSAID) and advise caution with massage to reduce the risk of myositis ossificans (formation of bony bars within the muscle). Treatment with ultrasound has generally no convincing effect.

Bandage: Certain bandages on the thigh have shown to be effective in reducing the risk of muscular bleeding in contact sports (article).

Complications: If steady progress is not experienced, you should be medically (re)examined to ensure that the diagnosis is correct or whether complications for muscle ruptures have arisen.

Anatomy: A rupture can in principle occur to all muscles in the thigh, however, ruptures most often happen in the anterior muscle (M quadriceps femoris) which has the function of stretching the knee and flexing the hip. The anterior thigh muscle consists of four muscles (M vastus lateralis, M vastus medialis, M rectus femoris and the deep lying M vastus intermedius).

Symptoms: In slight cases a local tenderness is felt after being subjected to load (“sprained muscle”, “imminent pulled muscle”). In severe cases sudden shooting pains are felt in the muscle (“partial muscle rupture”, “pulled muscle”) and in the worst case a sudden snap is felt rendering the muscle unusable (“total muscle rupture”). The following three symptoms are characteristic in connection with muscle injuries: pain upon applying pressure, stretching and activation of the muscle (stretching knee) against resistance. With total ruptures a defect can often be seen and felt in the muscle, and above and below the rupture a swelling can be felt (the contracted muscle belly and bleeding). The most frequent place for partial ruptures on the anterior thigh is approximately 10 cm below the upper front iliac crest projection (spina iliaca anterior superior) in the rectus femoris muscle.

Acute treatment: Click here.

Examination: In very slight cases (light muscle sprains) with only minimal tenderness and no discomfort when walking normally, medical examination is not necessarily required. The severity of the tenderness is however, not always a measure of the extent of the injury. In cases of more pronounced tenderness or pain, medical examination is required to ensure the diagnosis and treatment. The diagnosis is usually made following normal medical examination, however, if there is any doubt concerning the diagnosis, ultrasound scanning can be performed, as it is the most suitable examination to ensure the diagnosis (Ultrasonic image). The larger the bleeding as assessed by ultrasound scanning, the longer the period needed to heal the injury (article).

Treatment: The treatment of the vast majority of muscle injuries today involves relief and rehabilitation. It is only in very rare cases that surgery is indicated (e.g. total rupture in the anterior muscle tendon close to the attachment on the upper knee cap where surgery is recommended very quickly (article). Even large ruptures in the thigh muscles will usually be able to be healed and rehabilitated without giving functional disorder (but often cosmetic disfigurement with an irregular thigh muscle).

Complications: If steady progress is not experienced, you should be medically (re)examined to ensure that the diagnosis is correct or whether complications for muscle ruptures have arisen.