Back Clinic Hip Pain & Disorders Team. These types of disorders are common complaints that can be caused by a variety of problems. The precise location of your hip pain can give more information about the underlying cause. The hip joint on its own tends to result in pain on the inside of your hip or groin area. Pain on the outside, upper thigh, or outer buttock is usually caused by ailments/problems with the muscles, ligaments, tendons, and soft tissues surrounding the hip joint. Hip pain can also be caused by diseases and conditions in other areas of your body, i.e. the lower back. The first thing is to identify where the pain is coming from.
The most important distinguishing factor is to find out if the hip is the cause of the pain. When hip pain comes from muscles, tendons, or ligament injuries, it typically comes from overuse or Repetitive Strain Injury (RSI). This comes from overusing the hip muscles in the body i.e. iliopsoas tendinitis. This can come from tendon and ligament irritations, which typically are involved in snapping hip syndrome. It can come from inside the joint that is more characteristic of hip osteoarthritis. Each of these types of pain presents itself in slightly different ways, which is then the most important part in diagnosing what the cause is.
The various muscles and tendons surrounding the foot play an important role as they provide stability to the lower parts of the body and allow the individual to move and flex their feet. These various muscles and tendons help support the ankles and allow leg movement. Many people will be on their feet constantly as the world moves and sometimes have to deal with various issues affecting their ability to walk. As the body naturally ages, many people will begin to shuffle their feet around, which causes strain on the foot muscles and can affect the calves and legs over time. To that point, it can lead to foot pain and other conditions that can affect the individual. Other issues that can affect the feet and its muscle could be incorrect footwear, how they are standing, or how they walk. When this happens, conditions like plantar fasciitis and trigger point pain can affect the feet differently. Today’s article focuses on the superficial intrinsic foot muscles, how trigger points and plantar fasciitis correlate with foot pain, and how to strengthen the foot muscles. We refer patients to certified providers incorporating techniques and therapies in the lower body extremities of trigger points affecting the feet. This helps many people with trigger point pain symptoms associated with plantar fasciitis along the intrinsic foot muscles. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a terrific way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
The Superficial Intrinsic Foot Muscles
As stated earlier, the foot has various muscles and tendons that allow stability to the ankles and allow movement when a person is walking. The foot has two muscle groups: the extrinsic and intrinsic muscles. Today we will look at the intrinsic foot muscles and how important these muscles are in the foot. Studies reveal that the intrinsic foot muscles are highly important as they are contained to the foot and contribute to supporting the medial longitudinal arch. The intrinsic foot muscles are superficial and help keep the toes straight while providing flexion and extension when in motion. The foot has about 29 muscles, including 10 surrounding the foot and ankle, while the other 19 are intrinsic and provide the roles for gait and posture. The 19 intrinsic muscles have the following:
Abductor Hallucis
Quadratus Plantae
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Abductor Digiti Minimi
Flexor Digiti Minimi
The Interossei Muscles
The Lumbricals
These muscles allow individuals to walk, run, or jog without pain. However, when the intrinsic muscles become impaired, studies reveal that intrinsic foot muscle function could be linked to various foot conditions that affect a person’s walking ability.
How Does Foot Pain Correlate With Plantar Fasciitis & Trigger Points?
Studies reveal that foot pain can cause an unpleasant sensory and emotional experience as many factors can affect how a person is walking and can lead to various issues affecting the lower extremities’ mobility. When multiple issues affect how a person walks, the intrinsic muscle and other muscles surrounding the ankle and foot could become strained and overlap with other foot conditions. When foot pain affects the intrinsic foot muscles, co-existing muscle impairments could affect the alignment, motion, load distribution, and muscle performance that involves the legs. When these impairments are causing foot pain, it can correlate with trigger points and conditions like plantar fasciitis that can affect a person walking. But how does foot pain connect with plantar fasciitis and trigger points?
According to Dr. Travell, M.D.’s book “Myofascial Pain and Dysfunction,” when tension starts to overload the foot, the intrinsic muscles develop tiny nodules in the muscle fibers and reduce the muscle strength of the medial arch. To that point, it can collapse and cause the foot to develop inflammation associated with repetitive actions that cause plantar fasciitis in the feet. When this happens, it can affect a person’s ability to walk, run, stand, and affect the lower extremities’ mobility. If it is not treated right away, it can cause muscle and joint pain in the hips, legs, knees, and lower back.
An Overview Of The Intrinsic Foot Muscles-Video
Have you been dealing with issues on your feet? Do you find it difficult to step down or walk? Or have you been rubbing your feet constantly to reduce the soreness in your feet? Many of these issues correlate with trigger points affecting the intrinsic foot muscles that could cause foot issues like plantar fasciitis. The foot has various muscles, like the intrinsic muscles, that allow gait and stability to the body. Multiple factors affecting the intrinsic foot muscles can lead to instability, muscle strain, tendon stress, and muscle and joint pain. This can affect how a person moves throughout the day and their quality of life. The video above explains where each different muscles are, which ones are extrinsic and intrinsic, and how each muscle helps with foot function. When various issues begin to affect the foot and cause mobility issues, multiple techniques are available to help strengthen the foot muscles and prevent future problems from affecting the feet.
Strengthening The Foot Muscles
Regarding trigger point pain affecting the intrinsic foot muscles, various techniques can reduce the pain-like symptoms of trigger points and prevent foot issues like plantar fasciitis from re-occurring. Studies reveal that light, non-weight-bearing exercises like cycling and swimming can minimize muscle overload on foot. Other ways to strengthen the intrinsic foot muscles are by stretching the toe flexors to help improve stability and prevent hypermobility in the foot. Other techniques that can reduce trigger points in the foot’s muscle fibers include using a cylindrical or spherical object and rolling under the arches to massage and loosen stiff muscles. Many of these techniques could help restore foot functionality and stability while reducing future issues like plantar fasciitis in the feet. To that point, allow people to walk pain-free again.
Conclusion
The foot has 29 muscles, including ten extrinsic muscles surrounding the foot and ankle and 29 intrinsic muscles on the foot. The intrinsic muscles are highly important for foot functionality as they are superficial and contribute to supporting the medial longitudinal arch. The intrinsic foot muscles also help keep the toes straight and allow flexion and extension when in motion. These muscles also help a person walk and stabilize the ankle. When various factors affect a person’s walking ability, it can lead to muscle strain and tendon stress to the foot, leading to the development of trigger points in the intrinsic muscle fibers and causing pain. This could cause foot conditions like plantar fasciitis and other co-existing muscle impairments that can affect the lower extremities’ mobility while causing muscle and joint pain in the hips, legs, knees, and lower back. Luckily there are available techniques that can help massage, stretch, and strengthen the intrinsic foot muscles while reducing trigger points and their associated symptoms from re-occurring. To that point, these techniques can allow many individuals to walk without feeling pain.
References
Card, Ryan K, and Bruno Bordoni. “Anatomy, Bony Pelvis and Lower Limb, Foot Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 27 Feb. 2022, www.ncbi.nlm.nih.gov/books/NBK539705/.
Gooding, Thomas M, et al. “Intrinsic Foot Muscle Activation during Specific Exercises: A T2 Time Magnetic Resonance Imaging Study.” Journal of Athletic Training, U.S. National Library of Medicine, Aug. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5094843/.
Hawke, Fiona, and Joshua Burns. “Understanding the Nature and Mechanism of Foot Pain.” Journal of Foot and Ankle Research, U.S. National Library of Medicine, 14 Jan. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2631512/.
Lim, Ang Tee, et al. “Management of Plantar Fasciitis in the Outpatient Setting.” Singapore Medical Journal, U.S. National Library of Medicine, Apr. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4853481/.
Soysa, Achini, et al. “Importance and Challenges of Measuring Intrinsic Foot Muscle Strength.” Journal of Foot and Ankle Research, U.S. National Library of Medicine, 26 Nov. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3544647/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
Regarding different destinations, our feet allow the legs and the lower body to move forward and stabilize the upper extremities from putting so much weight on the body itself. The lower portion of the body contains the hips, pelvis, legs, and feet. Within each section of the lower body, various muscles surround the joints and skeletal features of the lower half. For the hips, multiple muscles and tendons help support hip mobility and pelvic function. The legs work with the thigh as numerous muscles and tendons help the legs have more power to move. The lower portion of the legs works with the knee to allow extension and flexion to move as well. And finally, the ankles and feet work with various muscles to enable movement to the toes. The different muscles in the toes help stabilize the foot from causing issues to the ankles. However, when multiple injuries or factors begin to affect the muscles in the toes, it can lead to myofascial pain syndrome or trigger points to affect not only the toes but the entire portion of the legs and travel up to the hips.
Today’s article looks at the flexor muscles of the toes, how calf pain is associated with trigger points affecting the toes, and how different treatments and stretches can alleviate trigger points along the toe flexor muscles. We refer patients to certified providers that incorporate various techniques and therapies in the lower body extremities pertaining to trigger points affecting the legs, calves, and feet. This helps many people with pain symptoms along the flexor toe muscles, causing pain when doing everyday actions like stepping or walking. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a terrific way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
The Flexor Muscles Of The Toes
Have you been dealing with stability issues that are affecting the way you are standing? How about coping with unquestionable calf or foot pain? Do you feel aches in your big toe? Many of these issues affecting the feet are correlated with the flexor muscles in the toes. The flexor muscles are the flexor digitorum longus and the flexor hallucis longus. These muscles are located in the calf region of the lower leg and travel downwards to the ankle, forming the tendons for the feet and toes. Research studies reveal that the flexor digitorum longus muscle is a thin muscle located in the tibia’s deep posterior muscles and provides operational support to the four different sections of the toes and allows flexion. While other research studies reveal that the flexor hallucis longus muscle is a deep posterior muscle located in the fibula and provides flexion to the great toe while serving to plantarflex and inversion to the foot.
Now the flexor muscles work together to allow stability to the foot when a person is walking. Additional studies have shown that the flexor muscles are active as many people push off from the heel to allow movement to the toes and feet when stepping on the ground. This action enables the flexor muscles to contract and exerts much energy to allow the feet to move. However, when the body begins to age naturally, or various issues affect the lower body extremities, it can lead to multiple problems affecting a person’s mobility.
Calf Pain Associated With Trigger Points Affecting The Toes
As the body ages naturally, a person’s mobility will eventually begin to decline as they shuffle in their steps instead of picking up their feet to move. Studies reveal that when older adults start to age naturally, they tend to have a decreased foot posture that enables them to have a more pronated foot than a supinated foot. When this happens, it can reduce mobility in their legs while also causing stress to the flexor muscles and have a high occurrence in lower extremity injuries like patellofemoral pain or tendon dysfunction. Stress in the flexor muscles can lead to the potential development of trigger points along the flexor muscles, which can correlate to calf pain. Dr. Janet Travell, M.D.’s book, “Myofascial Pain and Dysfunction,” mentioned that trigger points along the toe flexor muscles could potentially cause impaired mobility and strain to the foot. Since the flexor muscles are located in the calves, many individuals that incorporate running, jogging, or walking as part of their daily lives can be affected. To that point, if a person is walking on uneven ground, it can cause the foot to be hyper-pronated and lead to calf pain. At the same time, trigger points in the flexor muscles can cause symptoms of muscle spasms and cramps which can become overlapping risk profiles for ankle and foot pain.
Treating Trigger Points Along The Flexor Muscles- Video
Have you been dealing with unexplainable muscle spasms in your calves? Do you feel unstable when walking for a long time? Or do you notice you shuffle instead of picking up your feet? Many of these issues are correlated with trigger points affecting the flexor muscles of the toes that are causing pain to the calves and feet. When it comes to trigger points along the flexor muscles of the toes, studies show that it can develop a “trigger toe” where the flexor hallucis muscle that is providing flexion to the great toe, is in pain which leads to foot issues like plantar fasciitis or ankle pain. Fortunately, all is still possible as there are different stretches and treatments to reduce trigger points associated with the toe flexor muscles. The video above explains where the flexor muscles are located in the calve region of the leg and demonstrates how to stretch the flexor muscle to prevent trigger points from returning.
Different Stretches & Treatments For Toe Flexor Muscles
When relieving foot and calf pain associated with trigger points affecting the flexor muscles, there are different stretches and treatments to reduce pain-like symptoms associated with trigger points. Studies reveal that incorporating various muscle-strengthening exercises that target the calves could improve postural balance on the feet. Or find the right footwear to prevent trigger points from appearing in the future. Other stretches like toe grasping and flexing the foot allow many pain specialists to locate where the trigger points affect the flexor muscles and develop a treatment plan to reduce the effects of trigger points along the toe flexor muscles. Some of the treatments include chiropractic care. Now, doesn’t chiropractic care only incorporate spinal adjustments on the back? Yes, it does, but it can also alleviate other issues. As stated earlier, the feet provide stability to the lower body extremities. When problems affect a person’s balance can cause limited mobility to the hips, affect the legs and feet over time, and develop trigger points along the way. With chiropractic care, chiropractors can restore hip mobility through mechanical and manual manipulation of the spine and can help loosen the stiff joints and muscles that are causing pain. Chiropractors can pinpoint where the trigger points are located and find ways to reduce the pain in the affected muscle.
Conclusion
The flexor muscles of the toes, the flexor digitorum longus, and the flexor hallucis longus allow stability and flexion to the toes. The flexor muscles are located in the calve region and enable the individual to walk without complications. When issues or injuries start to affect the feet, they could develop into overlapping issues that affect the flexor muscles and causes symptoms of instability in a person’s balance. If not treated right away, it could develop trigger points in the calf region and cause pain to the flexor muscles. Trigger points in the flexor muscles can cause stress on the flexor muscles, which then leads to foot issues like patellofemoral pain or tendon dysfunction. To that point cause impaired mobility and muscle strain on the foot. Luckily there are treatments and various stretches to reduce trigger points from developing further and improve stability in the body. To that point, allow the individual to walk without any foot pain.
References
Fowles, J V, and N M Newman. “A Case of ‘Trigger Toe.’” Canadian Journal of Surgery. Journal Canadien De Chirurgie, U.S. National Library of Medicine, July 1984, pubmed.ncbi.nlm.nih.gov/6744145/.
Goldmann, Jan-Peter, and Gert-Peter Brüggemann. “The Potential of Human Toe Flexor Muscles to Produce Force.” Journal of Anatomy, U.S. National Library of Medicine, Aug. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3406365/.
Kusagawa, Yuki, et al. “Toe Flexor Strength Is Associated with Mobility in Older Adults with Pronated and Supinated Feet but Not with Neutral Feet.” Journal of Foot and Ankle Research, U.S. National Library of Medicine, 11 Sept. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7488436/.
Murdock, Christopher J, et al. “Anatomy, Bony Pelvis and Lower Limb, Calf Flexor Hallucis Longus Muscle …” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK539776/.
Quinlan, Shayan, et al. “The Evidence for Improving Balance by Strengthening the Toe Flexor Muscles: A Systematic Review.” Gait & Posture, U.S. National Library of Medicine, Sept. 2020, pubmed.ncbi.nlm.nih.gov/32679464/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
The hip joint is a ball-and-socket joint composed of the femur head and a socket, which is part of the pelvis. The labrum is a cartilage ring on the socket part of the hip joint that helps keep joint fluid inside to ensure frictionless hip motion and alignment during movement. A labral tear of the hip is an injury to the labrum. The extent of the damage can vary. Sometimes, the hip labrum can have mini tears or fray at the edges, usually caused by gradual wear and tear. In other cases, a section of the labrum can separate or get torn away from the socket bone. These types of injuries are usually due to trauma. There are conservative hip labral tear tests to determine the type of injury. The Injury Medical Chiropractic and Functional Medicine Clinic team can help.
Symptoms
Symptoms are similar regardless of the type of tear, but where they are felt depends on whether the tear is in the front or the back. Common symptoms include:
Hip stiffness
Limited range of motion
A clicking or locking sensation in the hip joint when moving.
Pain in the hip, groin, or buttocks, especially when walking or running.
Night discomfort and pain symptoms when sleeping.
Some tears can cause no symptoms and can go unnoticed for years.
Hip Labral Tear Tests
A hip labral tear can occur anywhere along the labrum. They can be described as anterior or posterior, depending on which part of the joint is affected:
Anterior hip labral tears: The most common type of hip labral tear. These tears occur on the front of the hip joint.
Posterior hip labral tears: This type appears on the back of the hip joint.
Tests
The most common hip labral tear tests include:
The Hip Impingement Test
The Straight Leg Raise Test
The FABER Test – stands for Flexion, Abduction, and External Rotation.
The THIRD Test – stands for the Hip Internal Rotation with Distraction.
Hip Impingement Tests
There are two types of hip impingement tests.
Anterior Hip Impingement
This test involves the patient lying on their back with their knee bent at 90 degrees and then rotated inward towards the body.
If there is pain, the test is considered positive.
Posterior Hip Impingement
This test involves the patient lying on their back with their hip extended and their knee flexed and bent at 90 degrees.
The leg is then rotated outward away from the body.
If it results in pain or apprehension, it is considered positive.
Straight Leg Raise Test
This test is used on various medical conditions that involve back pain.
The test begins with the patient sitting or lying down.
On the unaffected side, the range of motion is examined.
Then the hip is flexed while the knee is straight on both legs.
The patient may be asked to flex the neck or extend the foot to stretch nerves.
The FABER Test
It stands for Flexion, Abduction, and External Rotation.
The test begins with the patient lying on their back with their legs straight.
The affected leg is placed in a figure four position.
The physician will then apply incremental downward pressure to the bent knee.
If there is hip or groin pain, the test is positive.
The THIRD Test
This stands for – the Hip Internal Rotation with Distraction
The test begins with the patient lying on their back.
The patient then flexes their knee to 90 degrees and turns it inward around 10 degrees.
The hip is then rotated inward with downward pressure on the hip joint.
The maneuver is repeated with the joint slightly distracted/pulled apart.
It is considered positive if the pain is present when the hip is rotated and diminished pain when distracted and rotated.
Chiropractic Treatment
Chiropractic treatment involves hip adjustments to realign the bones around the hip and up through the spine, soft tissue massage therapy to relax the muscles around the pelvis and thigh, targeted flexibility exercises to restore range of motion, motor control exercises, and strengthening exercises to correct muscular imbalances.
Treatment and Therapy
References
Chamberlain, Rachel. “Hip Pain in Adults: Evaluation and Differential Diagnosis.” American family physician vol. 103,2 (2021): 81-89.
Groh, M.M., Herrera, J. A comprehensive review of hip labral tears. Curr Rev Musculoskelet Med 2, 105–117 (2009). doi.org/10.1007/s12178-009-9052-9
Many individuals utilize their lower muscles to move around and stay active as each muscle does its job and allows mobility to the hips and thighs. In sports, the thigh muscles are utilized constantly to extend the legs and bend the knees, allowing a powerful force to win any sports competition. At the same time, various sports injuries can occur to the hips, thighs, and legs and can affect the muscles causing pain and discomfort to the lower extremities. A hamstring injury is one of the most common injuries that can affect the thighs, which can cause many athletes to be taken out of their favorite sport to recover from the injury. Today’s article looks at the hamstring muscle, how trigger points correlate with a hamstring strain, and how various stretches can reduce muscle strain on the hamstrings. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like upper thigh and hip pain treatments correlating to myofascial trigger point pain, to aid individuals dealing with pain symptoms along the hamstring muscles. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer
What Are The Hamstring Muscles?
Do you experience pain in the back of your upper thigh? When walking from one place to another, do you hear a popping sound in the back of your thigh? Or are you dealing with muscle tenderness in the back of your upper thigh? Many of these symptoms correlate with issues affecting the hamstrings causing trigger points to affect the upper thighs. As one of the most complex muscles comprising three muscles (semitendinosus, semimembranosus, biceps femoris), the hamstrings play a crucial part in daily activities. From simple actions like standing to explosive movements like sprinting or jumping, the hamstrings are known as posterior thigh muscles that begin from the pelvis and run behind the femur bone and cross the femoroacetabular and tibiofemoral joints. The hamstring muscles in the body play a prominent role in hip extension and is a dynamic stabilizer of the knee joint. To that point, the hamstring muscles are the most susceptible muscle that succumbs to injuries that can lead to disability in the legs and affect daily activities.
Hamstring Strain & Trigger Points
Since the hamstrings are the most susceptible muscles that can succumb to injuries, it takes a while for the muscle to heal, depending on the severity of the damage. Studies reveal that the hamstrings can occur injuries when a person is running or sprinting due to their anatomic arrangement, which causes the muscles to strain. To that point, depending on how much force has impacted the hamstrings, the injuries can lead to 3 of the following:
Grade 1: Mild pain or swelling (no loss of function)
Grade 2: Identifiable partial tissue disruption with moderate pain and swelling (minimal loss of function)
Grade 3: Complete disruption of the tissue with severe pain and swelling (total loss of function)
The pain that patients experience can be painful when walking, causing them to limp. In “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., stated that when patients are dealing with pain in their hamstrings, it could potentially be associated with trigger points along the three muscles, causing pain and disability in the upper thighs. The book also mentioned that when trigger points affect the hamstrings, it can lead to muscle inhibition, compromising hip stability. Another issue that trigger points associated with hamstring strain causes in the body are that when individuals are sitting down are likely to experience posterior pain in the buttock, upper thighs, and back of the knees. Luckily, there are various ways to reduce the pain along the hamstring muscles.
Trigger Point Of The Week: Hamstrings- Video
Have you dealt with pain along the back of your upper thighs? Does it feel uncomfortable when you are sitting down? Or do your hamstrings ache or feel tight after running for a long period? People dealing with issues in their hamstrings could be dealing with muscle strain associated with trigger points. The hamstring muscles play a vital role in the body as it allows the individual to walk, run, bend the knees and even extend the legs. The hamstring muscles are also the most susceptible to injury, causing disability to the legs. Studies reveal that trigger points associated with the hamstring muscles can lead to soreness or irritability in the muscle fibers that may interfere with the biomechanics and normal functioning of the lower limbs. The video above explains where the hamstrings are located and how the trigger points can cause referred pain to the hamstrings. To that point, trigger points can affect a person’s ability to walk and affect the surrounding muscles in the lower body while mimicking other chronic conditions.
Various Stretches To Reduce Muscle Strain On The Hamstrings
When the hamstrings become injured, the healing rate usually depends on how severe the injury is in the hamstrings. If a hamstring injury is mild, the tears or strains can heal within about three to eight weeks, and if the hamstring injury is severe, the tears or strains could be long as three months. When the hamstrings are tense and on the verge of tearing, many people should stop overusing the muscle. Various stretches can reduce muscle strain on the hamstrings and relieve tension from the hamstrings to allow mobility back to the legs. Studies reveal that manual ischemic compression on the upper thigh muscles can significantly reduce pain in the lower limbs. This allows the individual to manage the trigger points associated with the hamstrings and reduce the chances of them re-occurring in the legs.
Conclusion
As the most important muscle in the lower body extremities, the hamstrings play a crucial part in the body as they allow the individual to walk, run, and stand without feeling pain. However, even though they are important muscles, they are susceptible to injuries. When the hamstrings become injured, the recovery process varies depending on the severity and can develop trigger points along the muscle fibers. To that point, it causes referred pain along the upper thigh muscle and affects a person’s ability to walk. Fortunately, incorporating various stretches to the hamstrings can alleviate the pain and reduce the trigger points from re-occurring in the muscle. This allows mobility back to the legs, and many individuals can resume their daily activities.
References
Esparza, Danilo, et al. “Effects of Local Ischemic Compression on Upper Limb Latent Myofascial Trigger Points: A Study of Subjective Pain and Linear Motor Performance.” Rehabilitation Research and Practice, Hindawi, 4 Mar. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6425406/.
Poudel, Bikash, and Shivlal Pandey. “Hamstring Injury – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 28 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK558936/.
Rodgers, Cooper D, and Avaias Raja. “Anatomy, Bony Pelvis and Lower Limb, Hamstring Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 Jan. 2022, www.ncbi.nlm.nih.gov/books/NBK546688/.
Thummar, Ravindra C, et al. “Association between Trigger Points in Hamstring, Posterior Leg, Foot Muscles and Plantar Fasciopathy: A Cross- Sectional Study.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, 7 Aug. 2020, pubmed.ncbi.nlm.nih.gov/33218537/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
The hips and thighs have a working relationship as their jobs are to maintain stability for the legs and pelvis while supporting the upper body’s weight. These two body groups have various muscles, tendons, and nerves that have specific jobs that allow mobility to the lower body. Many athletes in multiple sports events use their thighs to exert a huge amount of power to be the best. This is due to the adductor muscles in the thighs that allow the athlete to win the event. These adductor muscles are voluminous in size and can become overstretched if the muscles have been worked out too much or injuries have caused dysfunction in the surrounding muscles, causing mobility issues. To that point, the adductor muscles will develop myofascial trigger points and cause hip and thigh pain. Today’s article looks at the two adductor muscles (Longus and Magnus), how myofascial trigger points affect the adductor muscles, and available treatments to manage hip adductor trigger points. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh and hip pain treatments correlating to myofascial trigger point pain, to aid individuals dealing with pain symptoms along the adductor muscles. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer
Adductor Longus & Adductor Magnus
Have you been dealing with groin pain located near your thighs? Do you feel muscle tenderness or stiffness when stretching your inner thighs? Or have you been feeling unstable in your hips or thighs when walking? Many individuals, especially athletes and older adults, could be experiencing myofascial trigger points associated with groin pain along their adductor muscles. The thighs contain several muscles and functions that allow many people to bend and extend their knees and hips. The adductor muscles allow the legs to move inward toward one another. The adductor muscles have five muscles: magnus, brevi, longus, pectineus, and gracilis. These muscles enable functionality to the thighs and hips, and we will look at two adductor muscles in the inner thighs. The long adductor muscle is a large, fan-shaped muscle that starts from the superior aspect of the pubis bone and travels down to connect at the thigh bone. Studies reveal that the adductor longus is a long and thin muscle with many actions for the thighs, including external/lateral rotation and thigh flexion.
Now the adductor Magnus is a large triangular-shaped muscle of the inner thighs that are important for thigh and hip function and stabilizing the pelvis. Studies reveal that even though the adductor Magnus is a large muscle in the inner thighs, its primary function is to allow the thigh to move in a larger range of motion without any pain inflicted on the thigh muscles. However, the adductor muscle can succumb to various issues affecting the thighs and groin regions of the body that can be overstretched and strain the body.
Myofascial Trigger Points Affecting The Adductor Muscles
Groin pain is a multi-factorial pain issue that affects the lower limbs, and its often due to muscle strain in the inner thigh muscles. This pain increases during vigorous activities and when there is a sudden twist in the hips. When the adductor muscles suddenly change in motion when the body is active, they can be overstretched and correlate to myofascial trigger points that can affect the inner thigh and groin regions. According to “Myofascial Pain and Dysfunction,” by Dr. Travell, M.D., patients with active myofascial trigger points in the two adductor muscles (Longus and Magnus) would become frequently aware of the pain in their groin and medial thigh. When the adductor muscles have myofascial trigger points in the inner thigh, diagnosing is difficult since the individual thinks they are suffering from groin pain when the pain is in their inner thighs. To that point, studies reveal that many individuals participating in various sports would suffer from groin pain due to myofascial trigger points affecting the adductor muscles. Luckily, there are multiple treatments to reduce the pain in the adductor muscles.
Hip Adductors: Trigger Point Anatomy- Video
Have you been dealing with groin pain when you are walking? What about experiencing unquestionable thigh pain that affects your daily activities? Or does stretching your inner thigh muscles seem difficult, causing muscle tenderness? Many of these symptoms correlate with groin pain associated with myofascial trigger points affecting the adductor muscles in the inner thighs. The adductor muscles allow mobility function to the thighs and enable the hips to have a wide range of motion. When the adductor muscles are overstretched due to a sudden change of hip rotation or injury has occurred on the thighs can lead to referred pain in the groin and inner thighs and develop myofascial trigger points. The video above shows where the trigger points are located in the hip adductor muscles. The video also explains where the pain is localized in the adductor muscles and the symptoms it produces that can affect the lower body extremities. Fortunately, even though diagnosing myofascial trigger points are a bit challenging, available treatments can manage trigger points along the hip adductors.
Available Treatments To Manage Hip Adductor Trigger Points
When myofascial trigger points affect the hip adductor muscles, many individuals complain about stiffness in their inner thighs and how they feel miserable when they don’t have mobility from their thighs and hips. As stated earlier, trigger points are a bit challenging when diagnosed, but they are treatable when doctors examine patients dealing with myofascial pain in their hips and thigh muscles. Once the diagnosis is complete, doctors work with pain specialists who can locate the trigger points and devise a treatment plan to relieve the pain. Available treatments like trigger point injections can minimize the pain and reduce the chances of trigger points returning. Other available therapies like exercising or stretching, especially for the hips and thighs. Specific exercises for the hips and thigh muscles can help strengthen the adductor muscles from suffering pain and can help reduce the pain symptoms. Another treatment is applying moist heat on the hip adductor muscles to release the tension from the tight muscles and allow mobility back to the hip adductors.
Conclusion
The adductor muscles work with the hips and thighs to allow a wide range of motions and extension to the knees and hips. The hips and the thighs allow stability to the lower body and support the weight to the upper body. When injuries or sudden changes start to affect the adductor muscles, it can lead to symptoms of groin pain associated with myofascial trigger points. Myofascial trigger points produce tiny nodules in the affected muscle that causes referred pain to the muscle group. When this happens, it causes the body to be dysfunctional and can affect a person’s mobility to function in the world. Luckily myofascial trigger points are treatable through various techniques and treatments that can reduce the chances of trigger points from re-occurring in the body.
References
Jeno, Susan H, and Gary S Schindler. “Anatomy, Bony Pelvis and Lower Limb, Thigh Adductor Magnus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 1 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK534842/.
Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
Takizawa, M, et al. “Why Adductor Magnus Muscle Is Large: The Function Based on Muscle Morphology in Cadavers.” Scandinavian Journal of Medicine & Science in Sports, U.S. National Library of Medicine, 27 Apr. 2012, pubmed.ncbi.nlm.nih.gov/22537037/.
van de Kimmenade, R J L L, et al. “A Rare Case of Adductor Longus Muscle Rupture.” Case Reports in Orthopedics, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4397006/.
The hips and the thighs have an established relationship where mobility and stability play a part in the body’s lower extremities. The lower extremities’ main job is to support the upper body’s weight while stabilizing the hips and allowing movement from the thighs to the legs and feet. When it comes to the thighs in the lower body, the various muscle surrounds the thighs and skeletal joints to allow the legs to move from one place to another. One of the muscle groups in the thighs is known as the quadriceps femoris. This muscle group is activated when a person is in motion and can succumb to injuries from trauma or normal factors. When this happens, issues like myofascial pain syndrome can affect the thigh muscle and cause referred pain to travel to the knees. Today’s article focuses on the quadriceps femoris, how myofascial pain syndrome is associated with thigh pain, and trigger point therapy on the quadriceps. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh and hip pain treatments correlating to myofascial pain, to aid individuals dealing with pain symptoms along the quadriceps for muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer
What Are The Quadriceps Femoris?
Have you been dealing with knee issues when you are walking? What about muscle tenderness or soreness in your thighs? Or have you been experiencing knee complaints when you are running? These areas of complaint are correlated with trigger points associated with thigh pain along the quadriceps femoris. As one of the most voluminous muscles in the human body, the quadriceps femoris is a group of muscles predominant in the thighs and is extraordinarily important. This muscle group is essential for daily activities like climbing the stairs or getting up from a seated position, allowing repercussions on the knees and hip joints. The quadriceps femoris consist of four thigh muscles to allow extension to the knees:
Vatus medialis
Vatus lateralis
Vatus intermedius
Rectus femoris
Studies reveal that these four different muscles fuse to form the quadricep tendon and stabilize the patella and thigh flexion at the hips and knee extension. This muscle group is highly important for athletes participating in sports events but can succumb to injuries through muscle strain.
Myofascial Pain Syndrome Associated With Tigh Pain
When the thigh muscles, especially the quadriceps femoris, can be overstretched and overused when in motion. Thigh pain is nothing to be alarmed about in its acute form; however, it can develop small nodules along the four muscle fibers that can cause referred pain to the hips and knees. To that point, it can correlate through quadriceps muscle strain to the thighs. Studies reveal that normal factors like kicking, jumping, or a sudden change of direction of running can potentially cause the muscle fibers to be overstretched and develop pain due to localized swelling corresponding to loss of motion from myofascial pain syndrome.
In “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., the book states that myofascial pain syndrome can invoke referred pain to the affected muscle or muscle group, causing the body to be dysfunctional. Myofascial pain syndrome associated with thigh pain can be managed through various treatments and could allow mobility back to the thighs, legs, knees, and hips. The book even mentions how the four muscles in the quadriceps femoris cause different pain issues in various body parts due to myofascial pain syndrome. For the rectus femoris, many people would complain about knee pain and weakness when climbing stairs. The vatus medialis would initially produce a toothache-like pain deep within the knee joint, often misinterpreted as joint inflammation. The vatus intermedius causes many individuals to have difficulty fully straightening their knees and causes them to develop buckling knee syndrome. And finally, the vatus lateralis could cause many individuals to complain about feeling pain when walking and that the pain is being distributed on the lateral aspect of the thigh, including the knees.
Trigger Point Therapy: Stretching The Quadriceps- Video
Have you been dealing with pain in your thighs and knees? Do you find it difficult to climb up or down the stairs? Or have you been experiencing inflammation in your knee joints? All these symptoms that you are experiencing in your thighs, knees, and hips correlate with trigger points created by myofascial pain syndrome affecting the quadriceps femoris. The quadriceps femoris is a voluminous group of muscles that allows the individual to do daily activities like climbing up or down the stairs, running, jumping, and getting up from a seated position. When various issues can cause the quadricep femoris to become overstretched and overused, it could develop myofascial pain syndrome/trigger points along the muscle fibers to mimic knee pain and cause dysfunction in knee mobility. Even though myofascial pain syndrome is poorly diagnosed, individuals can manage it through various treatments that target myofascial trigger pain. The video above explains where the quadriceps femoris muscles are located on the thigh and where the trigger points are in the muscle fibers. The video also provides various stretching techniques on the quadriceps to reduce pain-like symptoms along the thighs.
Trigger Point Therapy On The Quadriceps
When it comes to releasing myofascial pain syndrome on the quadriceps, treatments like dry needling, acupuncture, or manual stretching can help loosen and lengthen the quadricep muscles from becoming shorten and can reduce myofascial trigger points from causing more issues on the knees and thighs. At the same time, treatment alone can only go so far in rehabilitation unless the person dealing with myofascial pains syndrome associated with thigh pain do some corrective actions to prevent trigger points from reproducing on the quads. Actions like:
Avoid prolonged sitting
Stretching the quads as part of your warm-up
Sleeping with a pillow between the knees
These actions allow the quadriceps to relax and prevent pain-like issues from affecting the knees. To that point, these actions can help many individuals have mobility back to their legs and allow them to bend their knees without feeling pain.
Conclusion
The quadriceps femoris consists of four thigh muscles that fuse to enable mobility functions in the knees without pain. As the most voluminous muscle group in the body, the quadriceps femoris allows the thighs to function when in motion and allow the knees to extend. When various issues cause the quadriceps femoris muscles to be overstretched, it can develop trigger points/myofascial pain syndrome that mimics knee pain and can affect how a person is walking. Thankfully, various treatments specializing in myofascial pain syndrome can reduce the pain symptoms from the quadriceps femoris and bring back knee mobility to the legs.
References
Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Bony Pelvis and Lower Limb, Thigh Quadriceps Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 10 May 2022, www.ncbi.nlm.nih.gov/books/NBK513334/.
Kary, Joel M. “Diagnosis and Management of Quadriceps Strains and Contusions.” Current Reviews in Musculoskeletal Medicine, Humana Press Inc, 30 July 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2941577/.
Rozenfeld, Evgeni, et al. “The Prevalence of Myofascial Trigger Points in Hip and Thigh Areas in Anterior Knee Pain Patients.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, 14 May 2019, pubmed.ncbi.nlm.nih.gov/31987560/.
Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
Waligora, Andrew C, et al. “Clinical Anatomy of the Quadriceps Femoris and Extensor Apparatus of the Knee.” Clinical Orthopaedics and Related Research, Springer-Verlag, Dec. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2772911/.
When many individuals begin to work out or start training for an event, they incorporate various muscles to give optimal output and strength when doing a set of exercises. Many athletes or individuals trying to train for an event or to better themselves have to do a pre-workout routine involving various stretches to warm up the muscles before the actual workout and do stretches post-workout again. This ensures that the muscles are ready to give it their all when a person is working out. The body has various parts with different functions and jobs that help the body’s motor function. The upper body has the shoulders, arms, hands, elbows, neck, head, and chest to allow movements and stability. At the same time, the lower body has the hips, low back, thighs, legs, knees, pelvis, and feet to support the upper body’s weight and stabilize the lower extremities from collapsing. When various factors affect the body, it can lead to dysfunction and causes referred pain to different body locations that can mask chronic conditions. Today’s article looks at one of the lower body muscles located at the inner thighs, known as the pectineus muscle, how trigger point pain affects the inner thighs, and various stretches to strengthen the hip adductors. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh and hip pain treatments correlating to trigger point pain, to aid individuals dealing with pain symptoms along the pectineus muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer
What Is The Pectineus Muscle?
Have you been experiencing pain in your inner thighs? Do you find it difficult to play various sports? Do you feel tenderness or soreness in your thighs or near your groin? Most of these symptoms are associated with trigger point pain along the pectineus muscles that affect the thighs. The pectineus is part of the anterior thigh muscles that extend the leg to the knee joint. The pectineus works with another muscle known as the sartorius and a muscle group known as the quadriceps femoris. The pectineus muscle is responsible for flexion, adduction, and medial rotation since it is a hip adductor for the thighs. This muscle is important for various sports activities like running, skating, soccer, or basketball and can become overused due to overstretching the legs too far, thus developing trigger points in the pectineus muscle.
Trigger Point Pain Affecting The Inner Thighs
When athletes overuse their legs and overstretch the pectineus muscle, it can cause issues with the thighs, hips, and legs’ mobility causing referred pain to the lower body. This is known as trigger point pain and can be challenging when diagnosing where the pain is located. Studies reveal that trigger point pain affecting the inner thighs, especially the pectineus muscle, can mimic groin and hip pain, causing various symptoms in the lower extremities. The multiple symptoms can include:
Weak adductor muscles
Muscle fatigue
Decreased range of motion
Leg-length discrepancy
Various reasons can lead to the development of trigger point pain associated with the inner thighs along the pectineus; according to “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., stated that when patients are dealing with pectineus trigger points would complain about the referred pain surrounding the muscle but not the muscle itself. The book also mentioned that nerve entrapment could also be an issue since trigger points like to mimic other chronic conditions. Trigger points along the pectineus muscle can also develop associated with hip joint diseases like advanced osteoarthritis.
Treating Trigger Points In Hip Adductors- Video
Are you experiencing issues when moving around constantly? Do you experience pain in your inner thighs and hips? Or do you have difficulty rotating your thighs or hips? If you have been dealing with these issues throughout your entire life, it could be due to your pectineus muscles being affected by trigger points along your inner thighs. Trigger points (myofascial pain syndrome) develop tiny nodules along the muscle fibers, causing referred pain to the surrounding muscles that can cause dysfunction in the lower extremities. Studies reveal that myofascial trigger points can cause the affected muscles to be intensely sensitive and irritable, predominantly near the reflex muscle. To that point, it causes hip and thigh disability in the lower body. Fortunately, there are ways to reduce the pain and manage the trigger point pain along the pectineus muscle, as shown in the video above. The hip adductor muscles are being stretched and treated for trigger point pain and allowing mobility back to the hips and inner thighs.
Various Stretches To Strengthen Hip Adductor
Since the pectineus muscle is part of the hip adductor muscles, various stretches can reduce the chances of trigger points from future development while minimizing the pain that it is causing along the surrounding muscles. Studies reveal that multiple exercises and stretches for the pectineus muscle can help with hip flexion and stabilization. These stretches can help stretch and strengthen the hip adductor muscles while preventing groin pain associated with trigger points. Incorporating these stretches before and after a workout can reduce trigger points and allow hip mobility and thigh rotation back to the legs. This ensures that the trigger points along the pectineus muscle are managed, and the individual doesn’t have to suffer from referred pain issues on the thighs and can move around without pain.
Conclusion
As part of the hip adductor muscles, the pectineus is a small muscle that extends the leg to the knees and allows the thighs to flex, adduct, and rotate without pain. This muscle is important for many athletes participating in sports and can be easily overstretched to cause referred pain around the thighs. To that point, it can develop trigger points along the pectineus muscles can correlate to groin pain in the lower extremities. All is not lost, as various stretches and exercises can strengthen the hip adductor muscles and improve thigh and hip mobility. This allows athletes and individuals to continue playing the sport they enjoy.
References
Giphart, J Erik, et al. “Recruitment and Activity of the Pectineus and Piriformis Muscles during Hip Rehabilitation Exercises: An Electromyography Study.” The American Journal of Sports Medicine, U.S. National Library of Medicine, July 2012, pubmed.ncbi.nlm.nih.gov/22523373/.
Khan, Ayesha, and Abdul Arain. “Anatomy, Bony Pelvis and Lower Limb, Anterior Thigh Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 10 June 2022, www.ncbi.nlm.nih.gov/books/NBK538425/.
Kiel, John, and Kimberly Kaiser. “Adductor Strain.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 21 June 2022, www.ncbi.nlm.nih.gov/books/NBK493166/.
Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
Wada, Juliano T, et al. “An Anatomical Basis for the Myofascial Trigger Points of the Abductor Hallucis Muscle.” BioMed Research International, Hindawi, 22 Jan. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC6998759/.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
