yogabook / pathologie / rectus femoris syndrome

Rectus femoris-Syndrome

Definition of

Insertional tend opathy of the rectus femoris at its origin at the anterior inferior iliac spine (SIAI). Alongside insertion tend opathy of the adductor muscles, gracilis syndrome, this is one of the most common insertion tendinopathies in sports such as soccer, sprinting, hurdling and long jumping. They can be easily distinguished from each other by the different areas in which pressure pain occurs. The pain on exertion mainly occurs when the hip joint is flexed against resistance. Extension in the hip joint when the knee joint is sufficiently flexed shows the stretching pain of the origin.

Cause

1. Overuse, often due to risk factors as indicated below

Predisposing

1. Weakness of the antagonistic hamstrings
2. Shortening/contracture of the hip flexors Comorbidity often includes a hollow back and hypertonus of the autochthonous muscles of the lumbar spine

Diagnosis

1. Provocation tests for pain on pressure, pain on stretching and pain on exertion of the origin

Symptoms

1. Pressure tenderness, stretch tenderness during hip extension, strain tenderness during hipflexion-contraction force or use of high muscle power, especially in the area that strains the elasticity of the tendon.

Therapy

1. In the acute phase: rest, anti-inflammatory drugs if necessary. Only apply cooling/ice for a very short time!
2. Elimination of muscular imbalances
3. Stretching the rectus femoris and other possibly shortened muscles
4. Training weak muscles
5. Treatment of any existing comorbidities such as hollow back and hypertonus of the autochthonous muscles of the lumbar spine.

Asana practice

In this disorder, the type and extent of strain are not in a healthy relationship to the load-bearing capacity of the structures, in this case the tendon of origin of the rectus femoris. On the one hand, a reduction in load is required, particularly with regard to the use of high muscle performance. In other similar cases, high loads in eccentric contraction would also be discouraged, as these pose a greater risk to the tendon due to the higher muscular capacity. In practice, however, these types of loads hardly ever occur in normal movement sequences, even in sport, so that this factor should be negligible. What is needed, therefore, is a reduction in the resting tone and improvement in the flexibility of the rectus femoris, combined with strengthening, which should not be impulse-like, as in kicking or various jumps, but rather slow and reasonably evenly powerful.

The two functions of the rectus femoris must be taken into account: to extend in the knee joint and to flex in the hip joint. If both are performed at the same time, the muscle becomes increasingly shorter in sarcomere length, which often leads to spasm or at least to an uncomfortably high tone or, in the long term, to shortening. However, this may have been part of the original problem and is generally a predisposing factor for difficulties with this muscle, not only in the area of the original tendon. When training to strengthen the rectus femoris, frequent extension of the knee joint with the hip joint flexed should therefore be avoided, as should flexion of the hip joint with the knee joint extended.

Asanas

Asanas in 816: Stretching the rectus femoris
Asanas in 817: Strengthening the rectus femoris