Injuries to the Rectus Femoris: A Review of Evaluation, Management, and Return to Sport

Injuries to the rectus femoris (RF) are an infrequently reported injury and can range from mild muscle strains to full tears, including injuries to the proximal and distal tendons of the RF. Patients often present with anterior thigh pain sustained after kicking or sprinting and describe a sudden "pop" in their thigh. Magnetic resonance imaging is the preferred modality for diagnosing the location, type, and severity of pathology. To date, there is no current treatment algorithm developed for managing these injuries. Nonsurgical management consists of rest, stretching, anti-inflammatory medications, gradual strengthening, and progressive functional rehabilitation before returning to activity. Injection therapy is sometimes used as well. Surgical treatment has typically been reserved for full-thickness muscle tears and tendon avulsions in high-level athletes. The literature has demonstrated that elite athletes have a high return to sport rate and do not have long-term effects. This review seeks to discuss the epidemiology, pathology, and outcomes of injuries to the RF muscle. Injuries to the quadriceps muscle in general are outside of the scope of this review.