Symptoms

Patients with tendonitis in the thigh complain of pain in the affected area. The pain is usually described as burning, pulling and stabbing. Often the tendon hurts when the affected muscle is stretched.

This can be deliberate in the form of a stretching exercise or as part of the normal movement process when running. In addition to the pain, overheating and reddening of the skin over the inflammation may be present less frequently. Furthermore, hardening and pressure pains are noticeable.

In acute cases (e.g. stumbling steps) it can take up to 24 hours before pain and other symptoms appear. In the case of chronic inflammation of the femoral tendon (e.g. due to poor posture), calcification of the tendon can occur due to the long-term inflammatory process. This becomes noticeable by crunching or cracking noises during movement and can be painful. In addition, the long-term relief of the thigh (to avoid pain) can lead to restrictions in movement when walking.

Place of inflammation

Inflammation of tendons on the inner side of the thigh is not uncommon and common in competitive sports. On the inner side of the thigh are the adductors, i.e. the muscles responsible for contracting the legs towards the middle. These muscles have their origins in the area of the pubic bone.

The adductor tendons can become inflamed during rapid and unusual movements. Inflammation of the adductor tendons occurs repeatedly in footballers and other ball sportsmen and women from the performance sector as a sign of overloading, incorrect strain and lack of regeneration. The pain the affected persons complain about is often load-dependent and occurs when the adductors are used.

Since these are also stressed during normal walking, pain also occurs during everyday locomotion. It is important that when the adductors become inflamed, the affected muscles and tendons are spared. Acute treatment with ibuprofen, cold compresses and also Voltaren® compresses helps.

In the course of the disease, treatment with heat is possible. Pain on the outside of the thigh can be caused by an inflammatory process on the greater trochanter.The greater trochanter is part of the femur and is located near the hip. Tendons of various muscles (gluteal and hip muscles) attach to it.

Overloading or incorrect loading can lead to inflammation of the bursae (bursitis trochanterica) on the thigh bone. The bursa sacs have the task of absorbing the pressure from tendons and ligament structures so that they do not rub against the bone. In bursitis, not only the bursae but also the tendons that lie against these bursae often become inflamed.

The so-called tractus iliotiablis runs over the trochanter. This is a strong tendon ligament that runs along the entire outer side of the thigh from the hip to the knee. If the tractus iliotibalis has to work against strong shear forces due to incorrect posture or overloading (e.g. with bow legs), it can happen that the bursa at the greater trochanter becomes inflamed, since the tractus iliotibalis then rubs along very strongly.

This disease is called runner’s knee or ITBS. If the inflammation is caused by malpositioning, it must be corrected to prevent recurrent inflammation due to the unphysiological (unnatural) strain. If the inflammation is caused by an acute incident, such as a contusion trauma or incorrect movement, immobilization, cooling and treatment with anti-inflammatory drugs is indicated.

The quadriceps muscle is located on the front of the thigh. It is primarily responsible for the extension in the knee. Patients with an inflammation of the femoral tendon at the front of the thigh do not always have to suffer severe pain.

Sometimes a slight stiffness or a feeling of weakness in the quadriceps is mentioned. If the inflammation is only slight, the pain can be reduced by warming up well. If the inflammation is more severe, however, the pain and problems often become more severe during the course of the load (e.g. the training session).

Persons who practice sports with fast braking, starting and directional changing movements (e.g. tennis, basketball or other sports involving short sprints) are often affected. In principle, however, any sport can be causal, in which longer running units, jumping, squatting and short sprints are involved. All these movements result in a long, continuous or short, abrupt and intensive strain on the quadriceps tendon.

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Pain in the front thigh

Pain on the back of the thigh can have different causes depending on its location. Inflammation of the tendons in the gluteal muscles is often associated with inflammation of the bursa in the area of the greater trochanter of the thigh bone. Reasons for this can be a fast-moving tendon or snap hip – a tendon repeatedly slips or snaps over the trochanter and irritates this or the bursa that lies there.

The tendons can also become inflamed in the process. In such cases, a possible difference in leg length must also be considered. But here again, excessive physical activity may be a possible cause.

An inflammation of the thigh tendon, which is located approximately in the middle or lower third of the back, affects the tendons of the ischiocrural musculature. These are the muscles that stretch the hip and bend the knee. The tendons of this muscle group are shortened in many people.

This is due to the fact that nowadays we sit a lot and do not run as much distance. This can also be caused by a bad posture of the leg. Often, however, people who are active in running or who have just started running training are affected.

Inflammation of tendons in the knee is not uncommon, especially in the front. This is the tendon of the large knee extensor, the quadriceps muscle. Its tendon may also be subject to long-term degenerative damage, in which case it is called tendinosis.

A permanent incorrect strain or acute trauma (e.g. during sports or in the course of a lunge) can be the cause. In case of knee pain, injuries of the cruciate ligament apparatus, the collateral ligaments or the menisci should always be considered. This can be ruled out by an orthopedist.

If pain in the hollow of the knee is indicated, an inflammation of the tendons of the ischiocrural muscles – these are the muscles that run along the back of the thigh and start at the knee – is possible, although this is rather rare. A palpation examination by the doctor can rule out a Baker’s cyst (bulge of the knee capsule into the hollow of the knee) as the cause of the complaints.Inflammation of the tendons in the groin usually manifests itself as pain as well as swelling, redness and overheating of the affected groin. The cause of the tendon inflammation is usually overloading, which is why athletes (especially running athletes) are particularly affected by the disease.

In principle, all muscles that move from the pelvis to the thigh can be affected by the tendon inflammation in the groin, but it is usually the hip flexor (Musculus Iliopsoas) that causes the discomfort. The therapy of the tendon inflammation in the groin initially consists of physical rest, the leg should be elevated. Cooling the groin and taking anti-inflammatory and analgesic medication is also useful at the beginning of the disease.

In the course of the disease, the strain should be gradually resumed under physiotherapeutic observation. More about this:

Tendinitis in the groin

The quadriceps is the largest muscle on the front of the thigh. At the hip it contributes to hip flexion.

At the knee it causes an extension. The quadriceps tendon is located at the lower end of the quadriceps and extends from there to the kneecap, where it merges with the patellar tendon. Inflammation of the quadriceps tendon is usually caused by chronic overloading of the tendon.

Particularly in professions that involve a lot of kneeling (e.g. tilers), the patella tendon is often also affected by the inflammation. The inflammation of the tendon usually manifests itself as pain, which becomes more severe under stress. The basic treatment consists of sparing the affected leg and then slowly increasing the load.