My 20-mile Portland run on February 6, 2016

waist trimmer and foam roller to treat rectus femoris

Treating an obstinate rectus femoris

February 19, 2016 Comments (3) The Blog

Meralgia Paresthetica

Be careful, this post might numb you a bit. 😉

Look at the featured image of this post. It was an incredible, early February run through Oregon’s wine country. This week when I was challenged to change my ways, else I might have to stop running in such amazing places.

For the past few months, I’ve grown increasingly aware of a slight numbness in my lower right thigh that would spring up towards the end of a long run. By long run, I mean 10+ miles. I think it may have started after the Portland Marathon last October. I’m not entirely clear. But I distinctly became aware of it as soon as I started venturing out on 16-milers organized through a local running group.

The sensation wasn’t too bothersome. It felt like your skin after you apply benzocaine to stop a mosquito bite from itching. To the touch, it was almost a bit warm and dull. It was always in the same place: the outer right thigh, from mid-quadracep down to just above my knee.

About two weeks ago, it become a problem. I’d just completed a 20-mile through Portland, complete with elevation gain. It was really numb then. And when I headed out two days later for a 6-7 mile, it started to hurt. It was then that I realized my body was trying to tell me something.

The sensations would come on by the first mile, and by mile 3 the numbness would go the full range of temperature: Hot, cold, back and forth, and finally a deep, very painful burning. I’d stop, and it would go away. About one minute into restarting my run, it would come right back, numb and painful.

lateral-femoral-subcutaneousI did a little online research — you can never tell but it’s something — and discovered a common issue with runners, especially larger runners entering their 40’s. Some doctors call it “beer gut syndrome” and it’s essentially, the combination of added weight (guilty as charged), combined with increased activity (I’d increased weekly run distance from 25 to 40 — whoops — another blog post coming on that), can cause a pinching of a nerve in the hip. It can be caused by any number of things: A tight belt or uniform; Sitting prolonged periods in a tight position that squeezes the hip; Even diabetes, which can cause nerve damage, can bring it on. Regardless of the cause, the condition is the same: It’s called Meralgia Paresthetica. If untreated, it remains a nuisance. In some cases, the sensations can get much worse.

I went to the local clinic last Tuesday and met with my doctor. He immediately diagnosed it, commenting, “You’re one of the largest long distance runners I’ve ever met.” It occurred to me I had in fact been putting on the weight over the past months. The doctor summarized it best: “You can either keep the weight, or continue running, but something has to give. You can’t have both.”

So, I’ve set in motion a plan to trim down. Healthier eating, to begin with. And I’m trimming back on the excess mileage too, until the nerve heals. So far this week, I’m up to 22 miles. Ordinarily, tomorrow’s group run would put me at a total of 40+. But a schedule conflict means I’ll run on my own later that day, and likely keep my total mileage for the week to 30 or below.

A foam roller is great for loosening up tight muscles before a workout, but without weakening them by stretching.

My new friend: A foam roller to help loosen up tight muscles before a run.

Additionally, I stopped in today at Connect Physical Therapy for a session with Dee Ann, a PT doctor my running coach advised me on. She assessed my situation and, through a series of exercises, located the tightness in my upper, inner right thigh that is likely the source of the nerve pinch. She also determined my left hip is several millimeters higher than my right, caused by one leg being longer than the other. This results in different ranges of motion for twisting at the waist (this explains my difficulties turning on downhill skis). It also explains the difference in stride between each of my legs as I run. One always lands a bit further forward, the other one a bit further back. And in turn, that can lead to strains.

Dee Ann offered me an insert for the bottom of my right shoe, which would elevate my right hip by about 3 millimeters. I noticed the difference right away, and felt it wasn’t a good idea at this time. I’ve gotten through 40 years of life built the way I’m built, and training for upcoming races probably isn’t the best time to try something new.

Instead, I came away with a nice, giant foam roller, and exercises to help loosen up my lower half prior to running.

So where it’s at: I’m backing off some of the mileage, dropping some pounds, adding preventive rolling to my pre-run prep, and loosening exercises throughout the day. It’s a small price to pay to keep being able to do the things I love doing. And I’m hoping that term, “Meralgia Paresthetica”, eventually goes away just like the numbness it’s been causing.

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3 Responses to Meralgia Paresthetica

  1. David Golden says:

    They need to understand the runner’s self-image, and come up with something more glorious sounding than “beer gut syndrome.” Maybe “Just After the Holidays and I’m Right Back to Training Hard Like a Boss Syndrome.” JATHAIRBTTHLAB Syndrome might not cause serious damage, but it needs to be taken seriously for quality of life issues.

  2. Manu says:

    Hey David

    Few weeks back I was diagnosed with meralgia parasthetica. Caused by a tight weight lifting belt, while doing squats. I’m over 40, but not over weight. So no weight to lose.

    My wife recommended Arnica 30x, which completely solved the pain in seven days. After a couple of weeks I went back to the gym and the pain is back. Reading your blog I realize I need to stretch/foam roll loosen up before the workout.

    Thanks for the helpful post. Also would be great to know if you’re fully recovered.

    Thanks

  3. David says:

    Hi Manu,

    Thank you for the reply. Stretching is still a necessity, though not as bad, as my body has slowly adapted to this new “norm”. I in fact am noticing it now a bit in my left left, especially after very long runs and without enough stretching. So it goes back to the foam roller and stretching to stay limber. 🙂

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