Low back pain – rectus femoris
Low back pain with irritation of the L3, L4 nerve roots can cause pain and spasm in the rectus femoris and pain and spasm in this muscle will aggravate low back pain.
This muscle is one of four muscles called the quadriceps muscles. The quadriceps are the muscles in the front of the thigh and are responsible for straightening the knee.
The rectus femoris arises from an area in the pelvic bone known as the anterior superior iliac spine and the part of the bone just above the hip joint. It inserts into the upper edge of the kneecap (patella) and also into the tubercle at the front of the shin bone (tibia). Its action is to flex the thigh upwards (hip flexion) and straighten the knee (knee extension). It receives innervation from the L2-L4 nerve root via the femoral nerve.
Since the rectus femoris is the only quadriceps muscle that crosses the hip joint and the knee joint, this muscle is more vulnerable to trauma than the other three quadriceps muscles (vastus lateralis, vastus medialis, and vastus intermedius). .
When the hips and knees are bent, such as when sitting, bending, or squatting, the rectus femoris and tensor fascia lata muscles are tight at the hip and overstretched at the knee. This predisposes the muscles to be easily traumatized. In addition, aging of the L3, L4 nerve root, injury or irritation from the presence of degenerative arthritis of the spine, herniated disc or bulging disc are also responsible for the underlying neurogenic weakness in this muscle.
Since the quadriceps is essential for keeping the knee steady when descending steps, inclines, and in the gait phase after the heel strikes the ground, weakness of the rectus femoris and tensor fascia latae (which also has fibers from the L4 nerve root) can predispose the person to falls.
To strengthen the rectus femoris and tensor fascia latae muscles, the principle involves education beginning first with shortening contractions of the spinal extensors from the neck to the lower back and hip extensor muscles. Hip flexor stiffness is secondary to unbalanced contraction of the hip flexor muscles, such as the rectus femoris, tensor fascia latae, adductor muscles, and iliopsoas muscles, in the presence of weak back extensors and the hip, as the gluteus maximus, the lower part of the adductor magnus. muscle and hamstring muscles. When the knee is flexed, the hamstring muscles are not involved in straightening the hip (extension). Therefore, most of the strength of the hamstrings is directed to bending the knee (flexion).
Health education to shorten the contractions of the spinal extensor and hip extensor muscles, such as the gluteus maximus and adductor maximus, should be done first to restore strength to these muscles. These extensor muscles are the main muscles constantly exposed to lengthening contractions at the hip that weaken them.
At the knee, weak extension force results in unopposed traction of the knee flexor muscles. Shortening and spasm of the knee flexor muscles, such as the hamstrings and gastrocnemius muscles, are primarily difficult to release. Therefore, shortening contractions of the knee extensor muscles, such as the rectus femoris, the tensor fascia latae, and the other three quadriceps muscles, must first be performed.
It is difficult to isolate these muscles to train them individually to shorten contractions. Selective activation of these muscles is best accomplished with motor point stimulation using the eToims Twitch Relief Method.
Therefore, in the treatment of lower back pain and discomfort, the rectus femoris must be treated along with all the other large and powerful muscles that cross multiple joints and are exposed to prolonged contractions. Therefore, treatments should involve all spinal muscles from the neck to the base of the spine, gluteus maximus, adductor maximus, and tensor fascia latae muscles at a minimum.
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