An Explanation for Various Rectus Femoris Strain Injuries Using Previously Undescribed Muscle Architecture

Abstract

We performed cadaveric dissection of the rectus femoris muscle to correlate the various lesions of strain injury seen with imaging studies to the muscular anatomy. The proximal tendon is composed of a superficial, anterior portion from the direct head, and a deep intramuscular portion from the indirect head. The muscle fibers arising from the anterior superficial tendon of the direct head travel in a posterior and distal direction to insert on the posterior tendon of insertion, giving the proximal muscle a unipennate architecture. Muscle fibers from the intramuscular tendon of the indirect head originate on both the medial and lateral sides of the tendon and insert on the distal posterior tendon to create its bipennate structure. Three chronic strain injuries involving the midmuscle belly substance were explored grossly and microscopically. It appears that one type of acute strain injury occurs in the midmuscle belly with disruption of the muscle-tendon junction of the intramuscular tendon resulting in local hemorrhage and edema. More chronically, this hematoma organizes into a fatty, loose connective tissue encasement of the deep intramuscular proximal tendon. Serous fluid from the hematoma may remain within the connective tissue sheath, creating a pseudocyst with the deep intramuscular tendon of the indirect head at its center. The muscle's anatomy helps to explain a different rectus femoris strain injury.

Epidemiology of Quadriceps Strains in National Collegiate Athletic Association Athletes, 2009–2010 Through 2014–2015

“…5,9À11 The rectus femoris is the most commonly strained quadriceps muscle, likely due to the fact that it is the sole biarticular muscle in the group, capable of both knee extension and hip flexion. 9 This role requires the rectus femoris to provide forceful eccentric contractions across both the hip and knee during rapid deceleration movements, increasing its vulnerability to strain. 9 Few researchers have examined the rates and patterns of quadriceps strains in student-athletes in the National Collegiate Athletic Association (NCAA).…”

“…9 This role requires the rectus femoris to provide forceful eccentric contractions across both the hip and knee during rapid deceleration movements, increasing its vulnerability to strain. 9 Few researchers have examined the rates and patterns of quadriceps strains in student-athletes in the National Collegiate Athletic Association (NCAA). The available data are almost exclusively from elite-level soccer players.…”

Conservative Treatment of Muscle Injuries: From Scientific Evidence to Clinical Practice

“…It has been shown that appropriate management decisions, return to training and competitions, and prediction of injury recurrence may all be enhanced with appropriate imaging examination Cross et al, 2004;Hasselman et al, 1995). Usually, US is the imaging modality of choice in visualizing sport-related muscle injuries, since it is widely available, safe, and inexpensive tool and allows dynamic evaluation which often can be helpful in distinguishing between a partial or complete tear of injured muscle.…”

Estudo comparativo entre a administração espinhal de lidocaína ou bupivacaína em jabutí piranga Chelonoidis carbonaria (Spix, 1824)

“…Nesta pesquisa, constata-se que todas as peças humanas e dos macacos, apresentaram dois tendões de origem, a cabeça reta e reflexa, sendo que nos humanos, a cabeça reta está firmemente fixada à espinha ilíaca antero-inferior e a cabeça reflexa fixada próximo à borda acetabular, aderindo-se firmemente à cápsula da articulação do quadril (Figura 2 e 3) e funcionando como estrutura anatômica importante durante os movimentos articulares contribuindo para a manutenção da cabeça do fêmur na fossa do acetábulo (BENJAMIN, KAISER e MILZ, 2008;DANGELO e FATTINI, 2007;HASSELMAN et al, 1995;VARISE et al, 2009;WARWICK;WILLIAMS in GRAY, 2005).…”