Gracilis Muscle Pain

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Written By Dr. Marcus Yu Bin Pai

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Introduction

The gracilis muscle is a small muscle that runs alongside your waist. This muscle’s primary function is to rotate your pelvis so that you can stand or walk more easily.

Many people suffer from gracilis muscle pain. Please do not panic, even though the pain you are experiencing is real and could be caused by a strain, sprain, or tear in your muscle or tendon.

We suggest you to read this article carefully because it might help you solve this issue.

Muscle Anatomy

The medial compartment of the thigh contains the long, slender gracilis muscle. The gracilis is a spiral unipennate muscle because of the spiral orientation of its muscular fiber bundles, which obliquely attach to the gracilis tendon’s anterior surface.

The Gracilis muscle is the most superficial muscle on the thigh’s medial side. It is thin and flattened on top, broad on the sides, and narrow and tapering on the bottom. The gracilis muscle has 5 to 7 muscle fiber bundle compartments, and each compartment has nerve branches running along it.

Origin

The gracilis muscle arises from the inferior ischiopubic ramus and the pubic body.

Insertion

The gracilis muscle attaches on the medial tibia at the Pes anserinus after descending practically vertically down the leg.

Nerve Supply

It gets a nerve supply from the anterior branch of the obturator nerve (L2-L4)

Blood Supply

Gracilis gets its blood supply from the medial circumflex femoral artery, deep femoral artery, descending genicular artery, superficial femoral artery, and the anterior branch of the obturator artery.

Function of Gracilis Muscle

The gracilis flexes the knee, adducts the thigh, and medially rotates the tibia on the femur because of its connection to the tibia.

Actions of the Gracilis Muscle

The gracilis muscle connects the hip joint to the tibia, resulting in actions at both the knee and hip joints. Let’s explore these actions in more detail:

  1. Adduction: When the leg is abducted, the gracilis pulls the tibia towards the hip, contributing to adduction. It acts as a weak synergist in this movement.
  2. Flexion at the knee: Similarly, the gracilis weakly synergizes and assists other muscles, like the hamstrings, in flexing the knee joint.
  3. Medial (internal) rotation: When the leg is externally rotated, the gracilis muscle contracts, causing medial or internal rotation of the leg. Medial rotation and internal rotation refer to the same action.

The Pes Anserinus: A Unique Connection

The insertion of the gracilis muscle, is on the proximal medial tibia. The tendons of the gracilis, sartorius, and semitendinosus muscles connect closely to each other at an area called the pes anserinus.

Translated from Latin, pes anserinus means “goose foot,” a name derived from the tendons’ resemblance to a goose’s foot with webbing between its toes. This webbing represents the tendons and other tissues surrounding the connecting tendons.

Trigger Points of Gracilis Muscle

When a muscle is contracted, a trigger point can be felt on one of the muscle fibers. The term “knots” or “spasms” is frequently used to describe trigger points, which typically develop in muscles that are overly tight or inflamed. 

The gracilis muscle trigger points are most frequently discovered in the upper thigh and buttock region. The leg, ankle, and foot are also home to the gracilis muscle’s trigger sites. Long periods of sitting and standing, as well as moving heavy objects, can cause them (particularly if you have bad posture).

 

Causes of Gracilis Muscle Pain

There are numerous reasons why the gracilis can hurt. An athletic injury or a fall onto an extended hand can cause strain or damage to the hip joint, leading to injuries in this area. It might also be brought on by repetitive motions that strain the area where this muscle attaches, such as working at a computer for extended periods without resting or lifting your legs when seated at a desk.

Running, cycling, and jumping are just a few of the motions and activities that require the gracilis muscles. These muscles may become sore and tired if they are overworked or injured. So, trigger points are also important causes of gracilis muscle pain.

Gracilis pain can also be caused by other issues such as arthritis, tendonitis, bursitis, injury to the ligament around your knee cap (cruciate ligament), or a torn meniscus (cartilage)

Pain Patterns and Symptoms

Tensions and/or shortenings in this muscle commonly cause localized discomfort in the posterior thighs. Medial thigh pain is the predominant symptom of transferred pain, while anteromedial knee pain is the subsequent sign.

These muscle trigger points may result in extra discomfort in the buttocks, down the back of the thigh, and on the medial side of the calf.

Identifying a Gracilis Strain

If you’re experiencing medial knee pain along with tightness in your adductors (inner thigh muscles), the gracilis muscle could be the culprit. To determine if this is the case, follow these steps:

  1. Press and probe the groin region. Do you feel any burning, pinching sensations or tenderness? If so, this might indicate a strained gracilis muscle.
  2. Examine the medial thigh. Is it tight and tender? Does pressing on the area cause pain to radiate towards the inside of your knee? If yes, this further supports the possibility of a gracilis strain.

Management Of Gracilis Muscle Pain

When trauma causes Gracilis muscle discomfort, it can be treated with rest, cold pack application, then heat, compression, and elevation.

Painkillers (NSAIDs) and muscle relaxants (skeletal muscle relaxants) may occasionally be required for the symptoms to lessen or disappear.

If you are experiencing muscle discomfort, you should visit a specialist specializing in musculoskeletal conditions. Muscle discomfort comes in many forms, and the underlying reason affects the diagnosis.

Rest, ultrasound, ultrasound-guided steroid injection, anti-inflammatory drugs, physical therapy, electrical stimulation treatment, and surgical nerve or tendon transfer are just a few methods used to treat muscle discomfort.

Treating a Gracilis Strain with Rock Floss

To address a strained gracilis muscle, consider using rock floss, a compression band that can be wrapped around the affected area. Follow these steps to apply and use the rock floss:

  1. Position the rock floss high up in the groin region, wrapping it around with little to no tension.
  2. As you continue to wrap the floss around the thigh, apply about 50% stretch in the areas where the muscle feels tight.
  3. Once you’ve wrapped the entire thigh, tuck in the end of the rock floss to secure it.

Now that the rock floss is in place, perform the following exercise to help alleviate the strain on your gracilis muscle:

  1. Stand with your affected leg extended to the side.
  2. Drive your hip downward to create tension in the inner thigh.
  3. Push your buttocks backward, maintaining the tension.
  4. Return to the starting position and repeat this movement for a total of 10-15 repetitions.
  5. Unwrap the rock floss and rest before completing another set of 10-15 repetitions.

Final Take-away

Muscle pain or soreness is one of the most common causes of symptoms in the lower limbs. Muscle pain is almost always a result of overuse.

The gracilis muscle is very small. The gracilis muscle is vulnerable to strains when engaging in sports or jobs requiring repetitive knee flexion. However, there are instances where a bacterial infection, deep vein thrombosis, trauma, or malignant tumor are to blame for this illness. You should see a doctor for a proper diagnosis if you experience discomfort in this area, as with any injury.

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MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

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