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| Ref: https://www.yoganatomy.com/sartorius-muscle/ |
The incidence of upper thigh injuries include the adductor (23%), hamstring (12– 37%) or quadriceps (19%), whilst sartorius muscle injuries occur in 31–46%. The pathogenesis of muscle injuries is divided into extrinsic and intrinsic injuries.
Intrinsic injuries are caused by contraction or elongation of the muscle that mainly involve type II muscle fibers which rapidly contract. It extends between two joints, contracts eccentrically and has a fusiform muscle fiber arrangement, leading to destruction of the internal muscle fiber. There are 3 grade injuries categories based on the extent of the lesion: grade I involves a few muscle fibers within a bundle; grade 2 involves up to three/fourths of the affected muscle portion; and grade 3 involves more than three/fourths, and the lesion may then involve the entire muscle belly.
Extrinsic injuries include factors such as contusions and penetrating wounds that can involve all types of muscle fibers.
5 options of the sartorius stretching exercise
Exercise #1: Sartorius stand wall stretch: Hands are on the wall for maintain balance. Step target leg backward, then adduct as behind front leg, then medial rotation as toe in, then move pelvic forward.
Exercise #2: Sartorius stand leg curl stretch: Bend target knee with hand support, then situate target shin laterally, then extend hip joint without arch lower back.
Exercise #3: Sartorius semi side lying stretch: Lying on the side to the opposite side of the target leg that makes the target leg is behind. Target leg was pushed by hand forward. Then rotate the torso to mid line again.
Exercise #4: Sartorius side lying stretch: Shin should be lateral to thigh in the end of pose setting.
Exercise #5: Sartorius supine stretch: For beginners, you should supine on the elbow. For advances, you can lie on the back.
I hardly have seen patients with sartorius injury. Most of my rare cases always complained e.g. proximal anteromedial tibia pain which was pes anserine, VMO pain, fore - thigh pain, proximal lateral groin pain, MCL pain. I had to evaluate carefully to clear the root curse and site of injury.
One sample case, He was overlapped by one soccer player on the leg while his knee was bending. He went to see a doctor and he was diagnosed with a knee tendon or ligament injury. A few days later, he came and saw me at physio clinic for more investigation and needed some advice. After subjective examination and physical evaluation, they indicated sartorius tendon more than MCL. To answer the question was how long should he rest? I investigated him by sonography, then the injured site demonstrated grade I. So, we can say his injury was the result of an extrinsic factor.
One author found that injuries of the sartorius muscle most often occur in the area of proximal and distal attachment. At the proximal part, common activity of the sartorius muscle and TFL can cause ASIS avulsion that may be observed. At distal insertion, frequently repetitive movements leading to micro injuries and tissue loads in this area are met. In the result of this, inflammations of bursa anserina, tendon strains and rupture may take place in what was pes anserinus. Such injuries happen to: i.a. athletes, runners, jumpers and football players.
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| Pes anserine bursitis site (Ref: http://therundoctor.com/pes-anserine-bursitis/) |
The sartorius muscle is the longest muscle in humans. Its name derives from a Latin word “sartor” that did mean “a tailor”.
The sartorius muscle is situated superficially, moreover, it is distinguished by an original shape and a course. It has got a transverse section in the shape of a triangle with the base upturned. The proximal tendon of the sartorius arises from the anterior superior iliac spine. The muscle belly is like an S-shaped running obliquely across the upper anterior third of the thigh in an inferomedial direction and tape twists around the anterior to the medial surface of the thigh. The belly of the sartorius constitutes the anterior wall of the adductor canal. Then the belly turns slantwise forward at the medial epicondyle of femur which together with quadriceps — its medial head — serves as a “trochlea” for the sartorius muscle. Its distal insertion onto the anteromedial proximal tibia as a flat divergent tendon creating in its further section superficial part of the pes anserinus.
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| Sartorius muscle (Ref: https://www.pinterest.com/) |
The sartorius muscle is a biarticular muscle or two joint muscles. It is the only muscle of the thigh which bends both hip joint and knee joint. The sartorius is mainly a flexor of the hip with the accessory function of lateral rotation and abduction of the hip as well as flexion and medial rotation of the knee. So, there are 4 directions of muscle activity including hip flexion, hip abduction, hip lateral rotation, and tibia medial rotation with knee flexion which action is like a cross single leg chair sitting.
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| Ref: https://quizlet.com/ |
Moreover, it has worked as a hip and knee flexor starter that initializes the movement of flexion in both joints from the phase of full extension. Although the sartorius muscle is a weak external rotator and a weak abductor of the hip joint, it plays an important part in stabilization of the pelvis, especially in women.
In my physiotherapy experience, stretching this muscle was not as easy as many muscles because it did not provide obvious tension. However, the principle to stretch this muscle is the same as the others: stretch to the point where “tightness with pain” or “noticeable tension without pain” will hole at the point for 30 seconds of 3 - 5 reputations as demonstrated VIDEO.
Reference:
https://www.researchgate.net/publication/266027219_Anatomy_of_sartorius_muscle
https://theultrasoundjournal.springeropen.com/track/pdf/10.1186/s13089-019-0132-9.pdf
https://www.orthopaedicmedicineonline.com/downloads/pdf/B9780702031458000843_web.pdf
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