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Home > What Can Cause Limping? – Part V – Thighs

What Can Cause Limping? – Part V – Thighs

Robert J. Snyder, MD

Robert J. Snyder, MD

The thighs are anatomical workhorses, with the largest bone and muscles of the body which carry our weight, help us to lift heavy objects and to launch ourselves into a run or a jump. In this article, I will look at common issues with the thigh that may cause limping, what causes them and how they are treated. 

Quadriceps Muscle Injury – this group of muscles runs from your hip to your knee along the front of your thigh. Strains, sprains, and tears to the quads are common, especially in sports like football, rugby, and soccer. They can have acute injuries or happen due to overuse. The quadriceps tendon may also be involved, but this is less common.  Symptoms include pain, bruising, swelling, limping or inability to walk, a lump at the site of injury may be present, and an inability to fully extend or bend the knee.

Treatment includes rest, intermittent icing, NSAIDS, compression bandaging, elevation and Physical Therapy will be ordered.  For severe tears, outpatient surgery may be appropriate to repair the injury, especially if there is tendon involvement. Recovery will take up to six months for the most severe cases.

Adductor Injury (Groin Strain) – the adductor muscles are located on the inside of the thighs and help to pull the legs together and to raise the knees.  Athletes commonly injure these muscles and the tendon during sports activities that include jumping and pivoting.  Symptoms of injury include pain and tenderness in the groin area, swelling, limping or inability to walk, joint instability and bruising.  The injury can range from mild to severe and the muscle/tendon unit may be undamaged or may be totally compromised.

Treatment includes rest, intermittent icing, NSAIDS, activity modification, Physical Therapy and perhaps the use of crutches.  For chronic cases, surgery may be required to repair tendon damage.  Recovery can take anywhere from weeks to months.

Hamstrings – these are three large muscles that run along the back of the thigh from the hip to just below the knee. They are involved in almost all activities of ambulation, so it is bad news when you injure one or all of them.  Common in athletes, these injuries can take over a year to heal from, so prevention is key. Symptoms can be mild to severe and include pain, limping or inability to walk, tenderness at the back of the thigh, bruising and swelling.  The patient may have also heard a pop or snap at the time of injury.

Treatment for mild injuries includes NSAIDS, rest, intermittent icing, compression bandaging and elevation.  Crutches may be needed for ambulation.  Physical Therapy will be ordered.  More severe injuries, such as tears, may need outpatient surgical repair and will require much longer periods of recovery. 

Iliotibial Band – the IT band is tough connective tissue runs down the outside of your thigh between the hip and the knee.  It commonly becomes inflamed in runners, rowers, skiers, and those who play soccer. However, it can become inflamed, swollen, and painful in just about anyone and cause limping.

Treatment is Physical Therapy, NSAIDS, oral steroids, activity modification, rest, icing, dry needling, stretching and perhaps a change in training for athletes.  Steroid injections and PRP can be used for tough cases. Rarely is surgery ever performed to release the IT band.

Dead Leg/Contusion/Bruise – having a blunt force injury into the thigh can cause a major bleed in the large muscles, resulting in a massive bruise, swelling, a possible lump and difficulty walking, squatting or with stairs.  These are often seen in sports, or when landing awkwardly from a jump.  The quadriceps muscle is crushed against the femur, resulting in an injury that causes a temporary loss of or altered sensation in the injured leg, hence “dead leg”.

Treatment is rest, elevation, intermittent icing for 48 hours, compression bandaging, and in some cases Physical Therapy.  More severe cases will need crutches while healing takes place.  In a rare complication, bone can actually grow in the muscle, called myositis ossificans, and surgery may be needed to remove any boney material.  Most injured athletes can return to the field in one to two weeks while serious cases can take months from which to recover.

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