Time to look at your Quadriceps.
If you are seated, look down at your legs, and you will be looking at your quadriceps or quads.
Your quads are responsible for extending your lower leg forward.
Of the four quads, three of them find their origin on the trochanter of the femur an
d one; rectus femoris, originates at the anterior inferior spine of the ilium, and is responsible for knee extension and hip flexion. They all insert on the tibial tuberosity. If this last bit has managed to leave you more confused than ever, I will break this down into everyday terms.
Three of the four muscles come down from the top of your femur. Swing your leg up and down and the point of leg rotation in the hip area is where three of them are attached. Now put your hands on your hips, and the bump on the hip near your index figure is where your rectus femoris muscle is attached. The muscles then go down the leg, convert to tendons which then go over the knee cap and attach to your lower leg on the bump found just below your knee cap.
What can go wrong?
- The muscles can get overworked and sore.
- You can develop a muscle tear.
- The muscle can get bruised from impact.
The condition that many runners and some cyclists suffer from, is an imbalance in muscle strength. On the outside of the upper leg you get your vastus lateralis. On the inside you get the vastus medialis. Vastus medialis sometimes looks like a tear drop that sits above the knee on the inside of the upper leg. If the large outside muscle pulls the knee harder than the one on the inside, it can have the effect of pulling the knee cap toward the outside of the leg. This skew pulling of the knee cap will cause pain either under the knee cap or just under the knee cap in a U shape. The condition is known as Patella Femoral Pain Syndrome. On the first x ray you can see how the outer quad muscle is pulling the knee cap off line. On the second x ray you can see how the knee cap should position itself as the quads are pulled and the lower leg straightened. 
Patella Femoral Pain Syndrome can be mistaken for ITB and a few other conditions. If in doubt, book a leg assessment.
We have an article on Patellar Femoral Pain Syndrome.
Some important points.
– Remember to stretch the muscle group. The stretch should take you to a pain threshold of 5/10.
– People with PFPS can do a bit of cross-training. Swimming back stroke will strengthen your rectus femoris muscle which will help with knee cap tracking.
– Make sure that your bike is properly set up, especially if your quads are the first things to scream at you on a ride.
– Do not go into full squats if your knees hurt. In fact, for many, even lunges are not advised.
– Tight quads are inefficient muscles and therefore respond well to massage. https://sbrsport.me/2014/02/28/sport-massage-at-sbr-sport/
– Younger athletes who use the quads a lot can develop a problem at the insertion point of the muscle. This will normally show up as pain at the top of the tibia. You can read more about the condition here – https://sbrsport.me/2012/10/13/what-is-osgood-schlatters-disease/
Hope this helps.
Regards,
Mike Roscoe.
Kinesiologist.
