Meralgia Paresthetica

Black Butte: Three days of exploration

April 28, 2016 Comments (1) The Blog

Treating an obstinate rectus femoris

waist trimmer and foam roller to treat rectus femoris

Blasted, oppositionally defiant rectus femoris. Always stirring up trouble. Unless you show it who’s boss.

The rectus femoris is one the quadricep muscles found in your upper thigh. It happens to overlay several important nerves, including the lateral femoral cutaneous nerve. If pinched or otherwise made to feel insignifant, this nerve will numb your outer thigh or even cause stake-through-leg, burning “sensations.” It’s all part of a condition called meralgia paresthetica, and thankfully I’m moving beyond it.

It took several physical therapy sessions to fully understand what was going on with my right thigh, as well as what to do about it.

Looking back on what caused it all, it came down to these things: A love for running, unmonitored weight gain, and overly aggressive training for 2016 races. You put them all together, and something has to give.

I spend far too much time sitting. My work (which can extend into evenings and weekends) has me in front of a screen most of the time. This leads to overall stiffening of my body from the waist down.

Now add the an opposite activity — running — and the picture becomes clearer. Any type of activity in excess, can be a bad thing. Not enough in-between motions, like stretching, can put your body through the ringer.

In three physical therapy sessions, my PT was able to identify severe stiffness in my right thigh. Lying on the edge of the table, she had me hold one leg to my chest, while I let the other one hang down. She then used a large protractor-like device to measure the angle at which the dangling leg would bend.

She said for normal people, a range of 90-95 degrees is good, and for runners, she’d like to see up to 105 degrees. My left leg was in the 90 degree range. My right leg: 65 degrees. Boom.

rectus femoris muscleShe showed me an anatomical diagram of the human leg and was able to zero in on the cause of my condition. An overly tight rectus femoris, one of the four quadricep muscles, was literally tugging at everything and preventing adequate flexibility.

The solution was to adjust my exercises with the big foam roller, and to target that region of my upper thigh and hip. In addition to rolling the fronts of my thighs, I modified the routine to focus on the upper thigh, one leg at a time, by lifting the opposite leg off of the roller. This increased the pressure and depth of the roll on the target area. I then alternated this to ensure both sides of the front of my hips were targeted, for even rolling.

An additional exercise involved angling the roller slightly off vertical, to a 20-30 degree angle away from me, and gently rolling my inner and upper thigh along the roller. I then alternated this with the other leg.

Ultimately, these exercises were designed to roll out the stiffness in that muscle group, and prevent nerve pinching.

Beyond this, I added one more item to my toolkit: A waist trimmer, which you can also simply call a beer gut girdle. I knew I’d put on a few pounds, but was surprised to learn how much. The idea of the trimmer was to limit parts of my waist from bobbing about while I run, which can happen on trails or when moving fast. The repetitive motion of these moving parts was also, I think, contributing to the overall nerve condition. My PT agreed and supported my use of the trimmer.

Finally, once on the road, I found that stopping and stretching the problem region, which could be as simple as a side lunge to loosen up tightness in the groin region, did wonders to alleviate any nerve issues that occurred while running. I found that stretching at intervals of every 1.5 to 2 miles, up through miles 5 or 6, would sufficiently loosen up my body so it could go as far as I wanted, without additional stretching beyond that point.

So to summarize: PT, rolling, waist trimmer, and stretching. And a ton of humility, not only going through these motions and realizing I’m 40 and this is how my running life looks now, but also to be able to write about this condition and share my experience.

My hope is that by reading this, you can understand that our bodies are incredibly complicated, living machines. They need ongoing maintenance and care. If we don’t take care of our bodies, our bodies will tell us why and how we should be caring for them, otherwise, we may lose out on the things we love most.

If ever you experience a physical ailment, by all means, tap into your knowledge, ask friends and running colleagues, and try some home remedies. But also, don’t be afraid to seek out help, either from a coach, or physical therapist, or even a doctor. If it’s important enough to treat and heal, you owe it to yourself to do whatever it takes, so you can get to that point of being complete once more.

If you’re in need of physical therapy, I have a recommendation for you. Dee Ann Dougherty and her crew at Connect Physical Therapy, in Lake Oswego, are incredible. She worked with me through this process, and the reason I was able to finish up Sunday’s Bend Marathon is entirely due to the treatment and knowledge she gave me. You can visit their site at the link below.

Happy trails,

David

Sources

Connect Physical Therapy
http://www.connectoregon.com/

Rectus femoris muscle
https://en.wikipedia.org/wiki/Rectus_femoris_muscle

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One Response to Treating an obstinate rectus femoris

  1. Jim mattern says:

    I’m glad you asked and you acted on my recommendation to see Dee Ann. A common error in runners:= too fast, too far, too soon. And office workers all share this syndrome to one degree or another.

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