Lower back pain with irritation of the L3, L4 nerve roots may cause pain and spasm within the rectus femoris and pain and spasm on this muscle will aggravate lower back pain.
This muscle is one in all the 4 muscles termed the quadriceps muscles. The quadriceps are the muscles within the front of the thigh and are accountable for straightening the knee.
The rectus femoris arises from an area on the pelvic bone often known as anterior superior iliac spine and the a part of the bone just above the hip joint. It inserts on the upper border of the kneecap (patella) and likewise to the tubercle on the front of the shin bone (tibia). Its motion is to bend the thigh upwards (hip flexion) and to straighten the knee (knee extension). It receives the L2-L4 nerve root supply through the femoral nerve.
Since rectus femoris is the one muscle of the quadriceps that crosses over the hip joint in addition to the knee joint, this muscle is more vulnerable to trauma than the opposite three quadriceps muscles (vastus lateralis, vastus medialis and vastus intermedius).
When the hip and knees are bent as in sitting, crouching or squatting, rectus femoris and tensor fascia lata muscles are very tight on the hip and excessively stretched on the knee. This predisposes the muscles to get easily traumatized. Moreover, aging of the L3, L4 nerve root, injury, or irritation from presence of degenerative arthritis of the spine, slipped disc, bulging disc are also accountable for underlying neurogenic weakness on this muscle.
Because the quadriceps is important for keeping the knee regular when happening steps, inclines and within the walking phase after the heel strikes the bottom, weakness of the rectus femoris and the tensor fascia lata (which also has L4 nerve root fibers) can predispose the person to falls.
To strengthen the rectus femoris and tensor fascia lata muscles, the principle involves education starting first with shortening contractions of the spinal extensors from the neck to the lower back and the hip extensor muscles. The hip flexor tightness is secondary to imbalanced contraction of the hip flexor muscles reminiscent of rectus femoris, tensor fascia lata, adductor muscles and the iliopsoas muscles within the presence of weak back and hip extensors reminiscent of the gluteus maximus, lower a part of the adductor magnus muscle and the hamstring muscles. When the knee is flexed, the hamstring muscles don’t take part in straightening the hip (extension). Due to this fact many of the strength of the hamstrings is directed to bending the knee (flexion).
The health education for shortening contractions of the spinal extensors and hip extensor muscles reminiscent of gluteus maximus and adductor magnus should be performed first to return strength to those muscles. These extensor muscles are the essential muscles continuously exposed to lengthening contractions on the hip making them weak.
On the knee, the weakness within the extension force leads to unopposed pull of the knee flexor muscles. The shortening and spasm within the knee flexor muscles reminiscent of the hamstrings and the gastrocnemius muscles are difficult to release primarily. Due to this fact shortening contractions of the knee extensor muscles reminiscent of the rectus femoris, tensor fascia lata and the opposite three quadriceps muscles should be performed first.
It’s difficult to isolate these muscles to be individually trained for shortening contractions. Selective activation of those muscles is best performed with motor point stimulation using the eToims Twitch Relief Method.
Thus within the treatment of lower back pain and discomfort, rectus femoris needs to be treated along with all the opposite large and powerful muscles that cross multiple joints and are exposed to lengthening contractions. Due to this fact, treatments must involve all the spinal muscles from the neck to the bottom of the spine, gluteus maximus, adductor magnus, and tensor fascia lata muscles at least.
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