Rectus Femoris Strain (“Hip Flexor Strain”)

The rectus femoris is one of the quadriceps muscles of the thigh. It crosses two joints – the hip and knee. It is commonly injured as the tendon at the front of the hip or in the muscle belly of the thigh. This injury is what many people refer to as a “hip flexor strain.” It is a common injury in sports such as soccer and football. Usually it involves a forceful movement such as immediately starting to sprint or forcefully kicking a ball, especially when the athlete’s foot strikes another player while trying to kick.

These injuries are almost always acute ones. The football player or soccer player will notice immediately that an injury has occurred. With a rectus femoris tendon strain, the athlete will localize the pain to the front of the hip. A sports medicine physician examining the player might notice a defect in this area if a full tear is present, but a full tear is unusual. More frequently, the physician will notice pain or weakness with resisted hip flexion or resisted knee extension. He or she might order x-rays to determine if the athlete pulled a small piece of bone off one of the bones in the hip, as you can occasionally see in young athletes who are not done growing. In high-level athletes especially, the physician might order an MRI of the hip. The MRI will help to confirm which tendon is involved. It can also give a better idea of the extent of injury and how long it might take the athlete to recover and return to sports.

As with most tendon and muscle strains, treatment is almost always nonoperative. Rest from the offending sport and ice to the area can be helpful. As the pain and swelling improve, cardiovascular exercise that does not stress the rectus, such as a stationary bike, can be helpful. As the athlete continues to improve, he or she will start jogging before progressing to a sport-specific rehabilitation program. Working with a sports physical therapist can help tremendously. Return to sports is likely, but it can be difficult to estimate the length of time prior to full recovery. Occasionally the athlete will get back in 1 to 4 weeks, but occasionally it can take 6 to 8 weeks or more.

If you have specific questions about hip flexor strains, please Ask Dr. Geier directly.

12 Responses to Rectus Femoris Strain (“Hip Flexor Strain”)

  1. Hi, very informative article. I have a recurring RF strain near the insertion of the hip joint. It occurred on a free range elliptical last june but has not healed right and not I have chronic tendonitis/tendonosis. It was getting better but I recently tweaked it and its bothering me again. Whats the best thing to heal this thing? I’m really at my witts end. stretching and exercises with no weight load? I donmt want to just rest it because I know it needs blood flow to help healing as well as keep the flexibility there. Much appreciated.

    • I can’t really say in your case without being involved, but working with a physical therapist to recover from the strain and return to exercise and sports can be helpful.

  2. Dear Doctor, thank you for the informative article. I have been found with an inflammation of the rectus femurs tendon in Jan 2014 after I have experienced strong/ drilling type of pain in my groin coming together with touchable tension in that part of the groin and even fevering. I was given steroids series of shots to reduce the inflammation and irritation of the tendon however until today (May 2014) I am still experiencing strong pain. MRI, X-ray and ultrasounds have been done for me in the hospital. From your experience would you have any advice why I am still in pain and my mobility is very poor? Doctors say that I should be already recovered but I am not. It seems that only irritation may be reduced due to the shots and ibuprofen but the pain is still there although I have retained from all activities. I hope that you could kindly share your opinion. With thanks! Kasia

  3. Hi, What are your own personal thoughts/experiences(if any) regarding the use of Kinesio Tape? I do realize there is virtually no science to support, or negate, the use of it.

  4. I injured my rectus femoris of right leg during soccer game this evening. I’m in great pain, I can light my leg n bend my knees without using my hands to move my right leg. Eg. I can’t straighten my right leg when I’m sitting, can’t lift my right leg to climb onto bed. Is this very serious n need surgery?

    At what degree of rectus femoris injury needs surgery?

    I’m in a country where I won’t want to visit the hospital here thus can forget about the surgery. If need surgery I would hv to fly bk home country for it.

    Pls advise. Thank you.

    • Surgery is rarely needed. If the tendon has pulled off bone and retracted a significant distance could be one instance.

  5. Hi Dr. Geier,
    My daughter 14,is an avid dancer,(15+ hrs weekly) and is having difficulties with her hip flexors. She has been seen by a Sports Med Doctor and he sent her to PT which helped, but continues to battle the pain. (She still does the HF stretches) She is saying that the pain goes from her hip and goes all around the top of her right leg. She wants me to find a doctor that specifically knows dance injuries because she doesn’t feel that the last Sports Doctor really knew the pain she was in. So with that being said, have you helped dancers in the past? She is becoming frustrated and is really being limited on what she loves best. Please let me know your thoughts. With kindest regards, A concerned Dancer Mom! :)

    • Rectus femoris strains can be difficult problems in dancers and other athletes. You might try the AOSSM website and use its Find a Doctor tool to find an orthopaedic surgeon who specializes in dancers in your area.

  6. My 10 year old son felt a pull in his right front thigh (I’m guessing his RF) at tennis practice a few days ago. He said that it only bothers him when he runs. He is scheduled to attend tennis camp tomorrow (Sunday) for a week. I’m certain there will be a lot of running at the camp! Bad idea to let him go? The incident happened on a Thursday, and Friday was a holiday so I was not able to speak or visit our PT. Your thoughts?

    • I can’t give you or him specific medical advice on this website. If an athlete has pain with certain activities, it can be a good idea to rest and avoid those activities for a brief period to try to let the injury heal. Physical therapy and/or seeing an orthopaedic surgeon can help if symptoms continue.

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