Rectus Femoris Tendonitis

Hey guys,

In February I injured my hip whilst squatting-- Originally thought it was Femoral Anterior Glide syndrome but then turns out it isn’t and it’s actually rectus femoris tendonitis. It hurts when I go below parallel and the pain is in the psoas, TFL and piriformis. I have been PVC rolling my quads and those areas and it’s getting a bit better-- I had box squatted during the past few months because it didn’t hurt but it’s preventing me from doing any free squats.

Any advice here? Any feedback will be appreciated! Thanks!

SMR on the quads and hip flexors will help as long as you are working on mobility at the hips and flexibility of your quads/hip flexors as well. I’d recommend also checking your ankle mobility, posterior chain/glute strength, and core strength. If the abdominal muscles are lacking, the hip flexors will have to take over for some of the movements.

If the glutes/posterior chain is weak, you can end up in an anterior pelvic tilt, causing the psoas, etc to become short and stiff. This short and stiff position will lead to a poor tissue quality and can cause the pain. If you lack ankle mobility, it can cause issues up at your hips as well. If you are lacking hip IR or ER, it can also cause problems.

I good starting point would be to have a movement assessment done. But you did make a great change already by switching to box squats for the time being until the pain subsides.

X-rays and scans don’t show any structural damage or anything serious like that. I just got some Ibuprofen–hopefully it’s gonna help clear the inflammation.

I don’t think that just taking ibuprofen is the best option. You need to find what exactly is causing the problem and try to fix that in order to find long term relief. The injury occurred about 4-5 months ago. That should have put you way past the acute inflammatory phase. This means that there is still some underlying issue causing the excess inflammation, which could be a muscular imbalance, mobility deficit, or poor/faulty movement pattern.

I think the reason there is still excess inflammation is because I didn’t truly rest-- After the injury occurred, I didn’t even rest lol (which looking back was so stupid). I did max effort deadlifts the next week (which didn’t bother it) and then I switched to box squats for the next 3 months. I also did box jumps once a week where I tried to jump onto a higher box each week (It put me in a deep squat position everytime I tucked my legs).

Then recently (about 6 weeks ago), I tried to free squat once to see whether it would be ok and even though I had hit a PR, there was pain after the session and I have since then stopped squatting and it is so frustrating… I really can’t afford physiotherapy and any sports massage, it is really too expensive for my budget so I’m opting for PVC rolling instead.

So basically, I think the injury is really because I haven’t given it enough time to rest. The doctor said there is no damage to the area but just inflammation.

At this point, I think it is worth considering changing your mechanics:

  1. foot wear
  2. stance width
  3. toe position

Something in the way you squat is causing the injury. In order to get rid of this, something must change.

beef

[quote]beefcakemdphd wrote:
At this point, I think it is worth considering changing your mechanics:

  1. foot wear
  2. stance width
  3. toe position

Something in the way you squat is causing the injury. In order to get rid of this, something must change.

beef[/quote]

This seems like the case.

  1. Foot wear-- I always wear converse chucks
  2. Stance width-- a little bit wider than shoulder width now
  3. Toe position-- around 35 degrees.

It seems like I need to bring my stance in but I have tried and it seems to hurt even more… I think there’s a reason though that I could parallel box squat without pain (pretty much). That tells me two things. I need to sit back more and I can’t go too much past parallel anymore (at least for a while after I recover). I think I have hurt myself because I used to squat really deep and force it too much. (Didn’t sit back enough)