The Sartorius muscle (in Blue) is one of the lesser known muscles of the human body. It however still it plays a crucial role in knee pain and position of the pelvis and the lumbar curve.

 

The sartorius muscle can become pulled or strained during high impact activities such as sprinting, jumping and running. Activities that make you forcefully push off place a lot of strain on this muscle. A direct hit to this area during sporting activities can also cause injury and pain. If you play sports such as hockey, rugby, football or basketball, you may be at a higher risk of injuring this muscle.

Symptoms

Sartorius muscle pain will be felt along the inside of your thigh or your groin area. Bringing your legs together will be painful. In some cases lifting your knee up can set off your symptoms. You may also have weakness and tenderness in the muscles of the inner thigh. Your physician can do a physical examination to determine if your pain is due to injury to this muscle.

Treatment

To relieve your sartorius pain, you will need a period of eliminating activities that make your pain worse. Using ice on the area and taking anti-inflammatory medications will also help. As you return to physical activity, your doctor may recommend using a bandage to wrap your thigh. A brief period of physical therapy will teach you exercises to relieve your symptoms and help prevent reinjury of the area.

 

Postural implications of the Sartorius.
The Sartorius is a critical postural muscle and plays a crucial role in the angle of pelvic tilt. A tight Sartorius muscle pulls the Anterior Superior Iliac Spine (ASIS) downward resulting in a lordotic lumbar spine. The Sartorius connects from the medial portion of the knee and travels upward to attach to the ASIS.

Anterior Tilt of the Pelvis

Tightening in the Sartorius results in stress not only in the medial part of the knee but also pulls the pelvic girdle downward front, which can cause excessive Kyphosis of the Thoracic spine and forward Head Carriage and pushes the abdomen forward.

The result is lower back pain and issues with digestion, reproductive functions, and excretion due to the additional pressure on the intestine and pelvic area. It can also result in stress on the spinal column and potential impingement of the spinal nerves arising from L4 and L5.

Downward, the tight Sartorius can create an inward rotation of the knees bringing them into a knock-kneed position. One can also check the condition of Sartorius by imagining that there was a direct line from the kneecap outward.  If those lines point inward, then the Sartorius could be in a tightened situation.

Pain and other chronic implications resulting from a tight Sartorius
Trigger points on the Sartorius’ muscle result in pain in the inner knee on the location where the muscle attaches to Tibia. Further trigger points are located all long the belly of the muscle and its path up to the ASIS. A tight Sartorius can also result in a condition called “Meralgia Paraesthetica,”which is a condition describing numbness in the front and outer thigh due to nerve impingement.

The most common symptom is the inability to lie on your side with your knees together as the pain in the inner knee makes this position uncomfortable.

Causes of tightening in the Sartorius
If you are a yogi who sits for a long time in the lotus position while meditating then, you are likely to

Trigger points of the Sartorius

find several fire spots or trigger points (Trps) along the Sartorius as this position keeps the muscle in a contracted state. Also, a sudden extension of the hip i.e. pushing the leg back like when running without warming up can result in trauma in the Sartorius. See the locations of Trps on image (marked in red). The Sartorius is often not the primary cause of postural imbalances…so the therapists should check associated muscle groups like such as the Quads, Psoas, and Adductors.

Self Treatment for a tight Sartorius;
You can sit on the floor or on a chair and palpate the muscle length to locate fire spots that generate a burning sensation. This muscle does not typically produce the same kind of pain as other trigger points. You can use double thumbs to compress and release the trigger points. Check if the spots become less tender in about 1 minute and if the points have softened. Once done proceed to stretching.

Stretching the Sartorius

Stretching the Sartorius

First sit in Vajrasana, then using the arms to support your weight gently fold the spine backward til back is flat on the ground. There should not be too much pain in this position but a light, good pain of stretching and releasing. This position works the Sartorius on both sides. If this position is too intense, then you can work them one at a time like shown here. You should feel the stretch along the entire length of the muscle.

 

What helps:

 

Extended Hand-to-Big-Toe Pose

In Extended Hand-to-big-toe Pose, maintaining solid grounding through the standing foot helps keep you steady.
Big hand to little toe pose

Also an interesting book I would recommend is :

 

https://www.amazon.com/Iyengar-Yoga-Asana-Alternatives-Knees/dp/0977858537/ref=sr_1_sc_1?s=books&ie=UTF8&qid=1512934626&sr=1-1-spell&keywords=Lois+Steinberg+THE+KNEEWS

 

 

 

I like the functional patterns stuff for knee issues. I find the lack of extension ability can impact knee function. Most people ‘cheat’ in poses like lunge and warrior 1, tipping the pelvis anterior to take the leg back, rather than extending the leg back *relative to* the pelvis.

I can’t recommend specific poses with out seeing the body in front of me, but i do see that pattern often, so can’t hurt to throw in some warrior 1 (done mindfully).

Also look for varus and valgus of the knee to see if that’s an issue also. You can find lots of good correctives for this in the functional patterns youtube. I can recommend others also if there is interest.

https://www.youtube.com/watch?v=Fj95GCWNDoQ