The rectus femoris is one of the four muscle bellies that make up the most powerful muscle of the thigh: the quadriceps cruralis. It is responsible for hip flexion and knee extension. As it is the only one of the four bundles to cross both joints (hip and knee), it is subject to intense forces that can trigger structural lesions. Its anchorage in the pelvis occurs at the anteroinferior iliac spine, a bony eminence located just above the hip joint.
Anterior Rectum Tendinopathy
Tendonitis, degenerative tendinosis and myotendinous rupture
Injuries of the anterior rectus are usually sports-related, caused by a violent eccentric contraction of the muscle, that is, in which the muscle is stretched while it is contracted. It is common in footballers, due to the movement of power shots. It may also occur in other sports activities that trigger similar mechanisms, or even after other traumas such as falls. It can also occur in a sub-acute or chronic manner in the form of repetitive trauma in which healing occurs in a deficient way either due to the absence of rest or persistence of the trauma, leading to a process of tendinosis.
In acute cases, groin pain and functional impotence are the most common manifestations. A voluminous hematoma may form in the inguinal region and on the thigh.
In sub-acute cases, the initial manifestation is pain or increasing discomfort at the end of the sporting activity, which progressively becomes installed during exercise and even constantly.
In the specific case of acute trauma with bone pulling, or in children/adolescents with subacute lesions in which the tendon progressively pulls the bone, a very prominent bone spine may form, which predisposes to a distinct pathology called sub-spinous conflict.
The most suitable treatment will depend on several variables such as the duration of the injury, location involved, type of sport, among others. In acute myotendinous transition injuries, rest and physiotherapy usually lead to very satisfactory results. Pure tendon injuries, or bone pulls may require surgical anchorage by mini-invasive or arthroscopic assistance. Chronic injuries, with subspinous conflict and sequelae may require removal of the spinal eminence and treatment of associated joint injuries.
