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Knee Pain Trigger Points


Trigger Point Therapy for Knee Pain and Thigh Pain

Knee pain is perhaps one of the most feared pain disorders. Knee injuries occur quite often in sporting events, and carry with them the stigma of impending knee surgery. The normal functioning of the knee joint depends greatly on the "balance" of muscular effort during walking, running, and other activities. Active trigger points in the muscles of the thigh can disturb this "balance", and alter the normal mechanics of the knee joint itself.


These trigger points frequently refer pain to the knee joint directly, and this pain must be understood as a warning that these thigh muscles have been overloaded and need time to recover. Besides pain, these trigger points frequently can cause a sudden buckling or weakness of the knee. Many types of knee pain, as well as stubborn post-surgical cases, respond very well to Trigger Point Therapy. 

Muscle groups in the front and back of the thigh, as well as the calf, can contain trigger points that produce pain in the front and back of the knee. The four muscles that are typically involved in knee pain disorders are:

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The Rectus Femoris Trigger Point that Causes Knee Pain

The Rectus Femoris is a large muscle found in the front of the thigh,and is part of the Quadriceps muscle group. It attaches to the pelvis above the hip joint and runs downward to attach to the knee cap (patella) and lower leg bone (the tibia).


When it contracts, it raises the knee by flexing the hip joint and/or straightens the leg by extending (straightening) the knee joint.


Trigger points in this muscle refer pain directly over the knee joint, and may also produce a weakness in the knee that is felt when walking down stairs.

Rectus Femoris Trigger Point Symptoms

Patients with active trigger points in this quadriceps muscle will complain of a deep aching pain in the front of the knee, and slightly above it in the lower thigh region. The pain may wake them up at night, depending on their sleeping position.

These patients may also experience something known as the "buckling hip" condition. This usually occurs when walking downstairs and can create a sudden fall if they aren't holding on to the handrail. The patient will often compensate for the buckling hip condition by walking on their tip-toe with the painful leg.

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The Vastus Medialis Trigger Points that Cause Knee Pain

The Vastus Medialis is part of the Quadricep muscle group and is found on the front and inside thigh region. It attaches along the large thigh bone (the femur) and runs down the thigh to attach to the knee cap (the patella) and to the larger of the lower leg bones (the tibia).


Like the other Quadricep muscles, the Vastus Medialis contracts to stabilize the knee during walking and running, and to extend the leg at the knee joint.


Trigger points in this muscle produce a deep pain in the knee joint and the inside lower thigh above the knee.

Vastus Medialis Trigger Point Symptoms

Patients with active trigger points in this muscle will often report that their knee pain has a toothache-like quality to it. Their pain will often be worse when they are trying to sleep.


These patients may also experience a "buckling knee" condition where their knee suddenly gives out causing the to fall while walking.

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The Vastus Lateralis Trigger Points that Cause Knee Pain and Outside Thigh Pain

The vastus lateralis is the largest muscle in the quadriceps muscle group. It originates along the posterior-lateral aspect of the femur bone and runs down the outside of the thigh to attach to the lateral aspect of the patella bone.


Contraction of this muscle produces extension of the lower leg at the knee.

Trigger points in the upper region of this large muscle refer pain to the outside of the thigh, while those in the lower region refer pain to the knee.

Vastus Lateralis Trigger Point Symptoms

Patients with active trigger points in the vastus lateralis muscle will complain of pain along the outside of the thigh and knee. The pain is usually more intense when they are walking and bothers them less while sleeping.

They may also complain of a stuck knee bone that doesn’t move up and down properly when they try to bend or straighten the leg. It may become locked with the leg slightly bent. Often they are forced to walk stiff-legged with the painful leg and may drag their foot. 

The Biceps Femoris Trigger Points that Cause Knee Pain

The Hamstring muscle group is composed of three muscles; the Semitendinosus, the Semimembranosus, and the Biceps Femoris. 

The Biceps Femoris attaches on the pelvic bone and the femur (thigh bone), and extends downward to attach to the smaller lower leg bone (the fibula) just below the outside aspect of the knee joint. When the Biceps Femoris muscle contracts, it flexes the knee to bend the leg. It is heavily used in walking, running and other activities.


Trigger points in this muscle refer pain to buttock, back of the thigh, and back of the knee regions. Additionally, they may cause "charlie horse" type cramping episodes. The pain is felt during walking, sitting, and may disturb sleeping. The muscle weakness created by these trigger points, will frequently cause the other thigh muscles to become overloaded and develop their own trigger points.

Biceps Femoris Trigger Point Symptoms

Patients with active biceps femoris trigger points will complain of posterior thigh pain and/or posterior knee pain that is worse when walking and often causes a limp. The pain may disturb their sleep at night and may concentrate in the buttocks when sitting.

Patients may also have symptoms related to quadriceps femoris trigger points, such as front of thigh and knee pain. The hamstrings and the quadriceps muscle groups share a strong biomechanical relationship and thus will often share trigger point activity.

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Related Instructional Videos from Dr. Perry

While the videos below were created to teach therapists how to locate and release these trigger points, many non-professionals have used them to learn these techniques successfully.

If you have a partner, a little time, you can use these videos to learn how to treat your own trigger points.

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Related Articles from Dr. Perry

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