What causes knee pain that shoots down to the foot. How is a pinched peroneal nerve diagnosed. What are the symptoms of a compressed nerve in the knee. How can you prevent and treat a pinched nerve in the knee.

Understanding Pinched Nerves: The Peroneal Nerve in Focus

A pinched nerve occurs when surrounding structures exert excessive pressure on a nerve, leading to symptoms in the area supplied by that nerve. While often associated with the back, nerves in various parts of the body can become compressed. In the knee, the peroneal nerve, a branch of the sciatic nerve, is particularly vulnerable to compression.

The peroneal nerve wraps around the outside of the knee before traveling down the lateral aspect of the lower leg. Its superficial position between bone and skin at the bottom of the knee makes it susceptible to compression from external factors. Understanding this anatomical arrangement is crucial for recognizing the potential causes and symptoms of a pinched peroneal nerve.

Common Causes of Peroneal Nerve Compression

Several factors can contribute to peroneal nerve compression in the knee area:

• Crossing legs for extended periods
• Prolonged squatting
• Bone fractures (tibia or fibula)
• Knee ligament injuries
• Tight lower leg casts or knee braces
• Knee-high boots
• Certain surgical positions
• Extended bed rest
• Thigh-high compression stockings
• Tumors or cysts near the nerve
• Complications from knee surgery

Is crossing your legs really that problematic? Surprisingly, it’s one of the most common causes of peroneal nerve compression. The opposite knee can exert direct pressure on the nerve, especially when maintained for long periods. This simple habit, often done unconsciously, can lead to significant discomfort and neurological symptoms.

Recognizing Symptoms of a Pinched Peroneal Nerve

The peroneal nerve plays a crucial role in both sensation and movement of the lower leg and foot. When compressed, it can produce a range of symptoms:

1. Weakness in foot dorsiflexion (lifting the foot towards the leg)
2. Difficulty turning the foot outward
3. Limited extension of the big toe
4. Numbness on the outside of the lower leg and top of the foot
5. Tingling or pins and needles sensation
6. Burning or sharp pain
7. Loss of sensation in affected areas

Can a pinched nerve cause lasting damage? If left untreated for two weeks or more, muscle atrophy can occur in the areas supplied by the compressed nerve. This underscores the importance of prompt recognition and treatment of peroneal nerve compression.

Foot Drop: A Telltale Sign

One of the most characteristic symptoms of peroneal nerve compression is foot drop. This condition manifests as difficulty lifting the front part of the foot, causing it to drag while walking. Foot drop can significantly impact mobility and increase the risk of tripping or falling.

Differential Diagnosis: Pinched Nerve in Knee vs. Lower Back

How can you distinguish between a pinched nerve in the knee and one in the lower back? While both can cause similar symptoms in the lower leg and foot, a pinched nerve in the lumbar spine typically also causes pain in the lower back or the back and outside of the thigh. The absence of these additional symptoms may point towards knee-related nerve compression.

However, it’s crucial to consult a healthcare professional for an accurate diagnosis, as proper identification of the source is essential for effective treatment.

Diagnostic Approaches for Peroneal Nerve Compression

Diagnosing a pinched peroneal nerve involves a combination of clinical examination and diagnostic tests:

• Medical history and physical examination
• Tinel’s sign test (tapping on the nerve to elicit symptoms)
• Knee X-rays
• Magnetic Resonance Imaging (MRI)
• Electromyogram (EMG)
• Nerve conduction studies

During the physical examination, your doctor may perform the Tinel’s sign test. When tapping on the affected nerve elicits a shooting pain down your leg, it strongly suggests peroneal nerve compression.

Advanced Imaging and Electrical Studies

While X-rays can reveal bone fractures or masses, MRI provides more detailed information about soft tissues, including the nerve itself and any surrounding structures that might be causing compression. EMG and nerve conduction studies assess the electrical activity in muscles and the speed of nerve signal transmission, respectively, helping to confirm the diagnosis and determine the severity of nerve involvement.

Treatment Options for Pinched Peroneal Nerve

The approach to treating a pinched peroneal nerve depends on the underlying cause and severity of symptoms:

1. Conservative management:
   • Avoiding activities that exacerbate symptoms
   • Physical therapy exercises
   • Bracing or splinting to support the foot
   • Anti-inflammatory medications
2. Surgical intervention:
   • Nerve decompression surgery
   • Removal of tumors or cysts
   • Repair of fractures or ligament injuries

How long does it take for a pinched nerve to heal? In many cases, symptoms resolve within days to weeks once the source of compression is addressed. However, recovery time can vary depending on the severity and duration of nerve compression.

The Role of Physical Therapy

Physical therapy plays a crucial role in both conservative management and post-surgical rehabilitation. A tailored exercise program can help maintain muscle strength, improve flexibility, and promote proper gait mechanics. Your physical therapist may also use modalities such as ultrasound or electrical stimulation to reduce inflammation and promote healing.

Preventing Peroneal Nerve Compression

Taking proactive steps can significantly reduce the risk of developing peroneal nerve compression:

• Avoid prolonged periods of leg crossing
• Take regular breaks during activities that involve squatting
• Ensure proper fit of casts, braces, and boots
• Maintain good posture and body mechanics
• Stay active and maintain a healthy weight
• Use proper positioning during extended bed rest

Is it necessary to completely avoid crossing your legs? While occasional leg crossing is unlikely to cause problems, it’s best to limit this habit, especially for extended periods. If you find yourself frequently crossing your legs, try to consciously alternate which leg is on top or use a different sitting position.

Ergonomic Considerations

Workplace ergonomics can play a significant role in preventing peroneal nerve compression. Ensure your desk and chair are at appropriate heights to avoid prolonged pressure on the outside of your knees. If your job requires frequent squatting or kneeling, consider using knee pads or alternating between different positions to distribute pressure more evenly.

Long-term Outlook and Complications

The prognosis for peroneal nerve compression is generally favorable when addressed promptly. However, prolonged compression can lead to more severe complications:

• Chronic pain
• Permanent muscle weakness
• Increased risk of falls due to foot drop
• Decreased quality of life

Can peroneal nerve damage be reversed? In many cases, yes. Early intervention and appropriate treatment can lead to full recovery. However, the extent and duration of compression play crucial roles in determining the potential for complete reversal of symptoms.

Monitoring and Follow-up Care

Even after symptoms resolve, it’s important to maintain regular follow-up care with your healthcare provider. This allows for early detection of any recurrence and ensures that preventive measures remain effective. Your doctor may recommend periodic nerve conduction studies to monitor the health and function of the peroneal nerve over time.

Understanding the intricacies of peroneal nerve compression empowers individuals to recognize early symptoms, seek timely medical attention, and take proactive steps in prevention. By addressing this condition promptly and comprehensively, patients can minimize the risk of long-term complications and maintain optimal lower limb function and quality of life.

Causes, Treatment, Recovery, and More

When surrounding structures put pressure on a nerve, it’s referred to as a pinched nerve. It causes symptoms in the part of the body that’s supplied by that nerve.

This article describes the causes and treatment of a pinched nerve in your knee.

A nerve becomes pinched when too much pressure is placed on it by the bone, tissue, or other structures around it.

This injures the nerve so it can’t function properly.

Although it’s most commonly associated with the nerves in your back, almost any nerve in your body can become pinched. Doctors call it nerve compression or entrapment.

There’s only one nerve going through your knee that’s at risk of being compressed. It’s a branch of your sciatic nerve called the peroneal nerve.

This nerve goes around the outside of your knee before traveling down the outside of your lower leg.

At the bottom of your knee, it lies between the bone and skin, which makes it vulnerable to compression by anything that puts pressure on the outside of your knee.

Traumatic injuries can lead to pressure on the nerve from inside your knee.

Common causes of a pinched nerve in your knee include:

• Crossing your legs. Compression by the opposite knee while you cross your legs is the most common cause.
• Squatting for long periods of time. This position put pressure on the side of your knee.
• Bone fracture. A fracture of the larger lower leg bone (tibia) or occasionally the smaller bone (fibula) near your knee can entrap the nerve.
• Knee ligament injury. The nerve can be pinched due to bleeding or inflammation when your ligament is injured.
• Lower leg cast. The top of the cast can press on the nerve.
• Knee brace. A tight or rigid brace can compress the nerve.
• Knee-high boots. When the top of a boot lands right below the knee, a pinched nerve can develop.
• Gynecologic or abdominal surgery. The equipment used to keep your legs rotated outward and knees flexed for most gynecologic and some abdominal surgeries can compress the nerve.
• Prolonged bed rest. Your legs tend to rotate outward and your knees flex while lying down, and the bed can put pressure on the nerve in this position.
• Thigh-high compression stockings. Designed to maintain pressure on your legs, these stockings can compress the nerve.
• Tumors or cysts. These can cause pressure when they’re located in or around the nerve.
• Complication of knee surgery. Rarely, the nerve is inadvertently pinched during knee replacement surgery or an arthroscopic procedure.

The peroneal nerve supplies both sensation and movement to the outside of your lower leg and the top of your foot. When it’s compressed, it becomes inflamed, which causes the symptoms of a pinched nerve.

Usually only the lining, or myelin, around the nerve is injured. When the nerve itself is also damaged, the symptoms are the same but more severe.

Weakness that limits your ability to lift your foot toward your leg, known as dorsiflexion, is often considered the most bothersome symptom. This causes your foot to drag when you walk.

Your ability to turn your foot outward and extend your big toe are also affected.

Other symptoms of a pinched peroneal nerve are felt on the outside of your lower leg and on the top of your foot. These include:

• numbness
• tingling or pins and needles feeling
• burning
• pain
• loss of sensation

If you’ve had a pinched nerve for two or more weeks, the muscles supplied by the nerve can begin to waste away.

Your symptoms may be intermittent or continuous depending on what’s pushing on the nerve.

The other common cause of these symptoms is a pinched nerve in your lumbar spine. When this is the cause, you’ll also have pain in your lower back or the back and outside of your thigh.

Your doctor will take your medical history and perform an exam to try to make a diagnosis and determine the cause.

The nerve in your knee can be felt as it travels around the top of your tibia, so your doctor may tap on it. If you feel a shooting pain down your leg, you probably have a pinched peroneal nerve.

Tests your doctor may order include:

• Knee X-ray: shows any bone fractures or masses
• Knee MRI: can confirm the diagnosis and show masses within the nerve and details of fractures of other problems in your bones
• Electromyogram (EMG): tests electrical activity in your muscles
• Nerve conduction test: tests the speed of signals in the nerve

Usually a pinched peroneal nerve will get better on its own within days to weeks once you stop the behavior or fix the condition that’s causing it.

If surgery is needed, your symptoms should disappear immediately, but it takes about four months to recover from surgery.

Things you can do to prevent a pinched peroneal nerve include:

• Avoid behaviors and activities that cause it such as crossing your legs, frequent squatting, and wearing knee-high boots.
• Tell your doctor if a cast or brace feels tight or is causing numbness or pain in your leg.
• Use devices that softly hold your ankles to prevent leg rotation during prolonged bed rest.
• Reposition yourself frequently during prolonged bed rest to avoid continuous pressure on the side of your knee.

The peroneal nerve that runs along the outside of your knee can become pinched when it’s compressed. Crossing your legs is the most common cause but anything outside or inside your knee that puts pressure on the nerve can do it.

A pinched nerve in the knee usually heals itself when the cause is removed, but surgery is sometimes needed to relieve the pressure.

Causes, Treatment, Recovery, and More

When surrounding structures put pressure on a nerve, it’s referred to as a pinched nerve. It causes symptoms in the part of the body that’s supplied by that nerve.

This article describes the causes and treatment of a pinched nerve in your knee.

A nerve becomes pinched when too much pressure is placed on it by the bone, tissue, or other structures around it.

This injures the nerve so it can’t function properly.

Although it’s most commonly associated with the nerves in your back, almost any nerve in your body can become pinched. Doctors call it nerve compression or entrapment.

There’s only one nerve going through your knee that’s at risk of being compressed. It’s a branch of your sciatic nerve called the peroneal nerve.

This nerve goes around the outside of your knee before traveling down the outside of your lower leg.

At the bottom of your knee, it lies between the bone and skin, which makes it vulnerable to compression by anything that puts pressure on the outside of your knee.

Traumatic injuries can lead to pressure on the nerve from inside your knee.

Common causes of a pinched nerve in your knee include:

• Crossing your legs. Compression by the opposite knee while you cross your legs is the most common cause.
• Squatting for long periods of time. This position put pressure on the side of your knee.
• Bone fracture. A fracture of the larger lower leg bone (tibia) or occasionally the smaller bone (fibula) near your knee can entrap the nerve.
• Knee ligament injury. The nerve can be pinched due to bleeding or inflammation when your ligament is injured.
• Lower leg cast. The top of the cast can press on the nerve.
• Knee brace. A tight or rigid brace can compress the nerve.
• Knee-high boots. When the top of a boot lands right below the knee, a pinched nerve can develop.
• Gynecologic or abdominal surgery. The equipment used to keep your legs rotated outward and knees flexed for most gynecologic and some abdominal surgeries can compress the nerve.
• Prolonged bed rest. Your legs tend to rotate outward and your knees flex while lying down, and the bed can put pressure on the nerve in this position.
• Thigh-high compression stockings. Designed to maintain pressure on your legs, these stockings can compress the nerve.
• Tumors or cysts. These can cause pressure when they’re located in or around the nerve.
• Complication of knee surgery. Rarely, the nerve is inadvertently pinched during knee replacement surgery or an arthroscopic procedure.

The peroneal nerve supplies both sensation and movement to the outside of your lower leg and the top of your foot. When it’s compressed, it becomes inflamed, which causes the symptoms of a pinched nerve.

Usually only the lining, or myelin, around the nerve is injured. When the nerve itself is also damaged, the symptoms are the same but more severe.

Weakness that limits your ability to lift your foot toward your leg, known as dorsiflexion, is often considered the most bothersome symptom. This causes your foot to drag when you walk.

Your ability to turn your foot outward and extend your big toe are also affected.

Other symptoms of a pinched peroneal nerve are felt on the outside of your lower leg and on the top of your foot. These include:

• numbness
• tingling or pins and needles feeling
• burning
• pain
• loss of sensation

If you’ve had a pinched nerve for two or more weeks, the muscles supplied by the nerve can begin to waste away.

Your symptoms may be intermittent or continuous depending on what’s pushing on the nerve.

The other common cause of these symptoms is a pinched nerve in your lumbar spine. When this is the cause, you’ll also have pain in your lower back or the back and outside of your thigh.

Your doctor will take your medical history and perform an exam to try to make a diagnosis and determine the cause.

The nerve in your knee can be felt as it travels around the top of your tibia, so your doctor may tap on it. If you feel a shooting pain down your leg, you probably have a pinched peroneal nerve.

Tests your doctor may order include:

• Knee X-ray: shows any bone fractures or masses
• Knee MRI: can confirm the diagnosis and show masses within the nerve and details of fractures of other problems in your bones
• Electromyogram (EMG): tests electrical activity in your muscles
• Nerve conduction test: tests the speed of signals in the nerve

Usually a pinched peroneal nerve will get better on its own within days to weeks once you stop the behavior or fix the condition that’s causing it.

If surgery is needed, your symptoms should disappear immediately, but it takes about four months to recover from surgery.

Things you can do to prevent a pinched peroneal nerve include:

• Avoid behaviors and activities that cause it such as crossing your legs, frequent squatting, and wearing knee-high boots.
• Tell your doctor if a cast or brace feels tight or is causing numbness or pain in your leg.
• Use devices that softly hold your ankles to prevent leg rotation during prolonged bed rest.
• Reposition yourself frequently during prolonged bed rest to avoid continuous pressure on the side of your knee.

The peroneal nerve that runs along the outside of your knee can become pinched when it’s compressed. Crossing your legs is the most common cause but anything outside or inside your knee that puts pressure on the nerve can do it.

A pinched nerve in the knee usually heals itself when the cause is removed, but surgery is sometimes needed to relieve the pressure.

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Knee pain: what could be the cause
Prolonged pain in the knee of varying intensity and nature indicates that pathological processes are developing in the cartilaginous, bone or soft tissues. Their appearance provokes a large number of factors, the primary source of which can only be detected using hardware diagnostics, puncture, biochemical and immunological analysis.

Causes of knee pain

All causes of discomfort in the knee joint area are divided into several groups.

Traumatic pains

They are often affected by athletes involved in running, jumping and playing sports. Sharp pain appears immediately at the time of injury, gradually fading away and giving way to swelling.

Such damage is divided into types:

• contusion: the result of a fall or direct blow to the knee. The pain is burning, sharp, but tolerable, gradually develops into aching, increases when walking. If the bruise is severe, then hemarthrosis is likely to develop. This will be evidenced by a swollen knee and a feeling of pressure on it from the inside;
• ligament rupture: reveals itself after a twist of the leg, when the limb is in an unnatural position for it. The pain is worse than a bruise, and it may feel like something inside the knee is torn, like a piece of tissue. Depending on the location of the damaged ligament, pain will be felt on the inside or outside of the knee and worsen with pressure or movement to the side. It’s hard to step on the foot. Hemarthrosis develops rapidly;
• intra-articular fracture: possible on impact, fall or twist. The pain is sharp, unbearable, sometimes accompanied by a characteristic crunch. Gradually, it spreads, maintaining its intensity, intensifies with light movements or touch, and does not fade for a long time. Hemorrhage and swelling appear very quickly;
• dislocation: direct injury to the knee from a blow or fall. The pain is accompanied by a sensation as if the knee were dislocated or the leg was giving way. You can lean on such a leg, but you can’t move. The deformation of the knee is visually visible, it gradually levels out due to the spreading edema. The pain alternately fades and grows, it is difficult to endure them. Possible hemarthrosis;
• pathological fracture: a consequence of the loss of bone strength due to the development of osteoporosis, osteomyelitis, tuberculosis and tumors. It is impossible to lean on the injured leg, the pains are dull, aching, similar to those that accompany bruises, do not differ in intensity. There is instability in the knee, instability of the joint, and a crackling sound when moving;
• meniscus rupture: you can get injured when you twist your leg, hit, unnatural bend and extension of the knee, sudden movements. The primary pain is sharp, shooting, and felt deep in the joint. Gradually, it decreases, but fills more space, increases during movement or leaning on the leg. The knee joint swells, intra-articular hemorrhage occurs. As a result, movement becomes impossible.

Inflammatory processes

Inflammatory pathologies are caused by:

• infections;
• consequences of injuries, vaccines, intoxication, allergies.

The nutrition of the joints is provided by a highly developed circulatory system, which supplies the synovial membrane and periarticular tissues with the necessary elements. The movement of blood contributes to the rapid development of inflammatory processes, and the network of nerve endings generates a painful reaction. Therefore, often inflammation is accompanied by synovitis and purulent accumulations.

The cause of pain in the knee due to the inflammatory processes occurring in the joint are:

• arthritis: occurs after trauma, infectious diseases, rheumatism. It has a chronic and acute form, characterized by dull, aching and pulling pains that manifest themselves gradually, intensifying in the evening after daytime stress on the legs. In the absence of treatment at this stage, the pain increases, their duration increases. Over time, swelling of the knee appears, the skin becomes red, the damaged area is hot. Synovitis aligns the contours of the knee with swelling, and purulent accumulations sharply increase the pain, make it jerky. The patient’s condition worsens due to the lack of proper sleep and symptoms of intoxication;
• synovitis: a form of complication of acute and chronic diseases of the joint. It develops quickly – from several hours to days. It feels like something bursting the joint from the inside, then it becomes painful. The pain is dull, it does not have a special effect on the general condition. Synovitis is fluid accumulation, so the knee becomes ball-shaped, gradually limiting movement. If the cause of synovitis is an infection, then the pain becomes pulsating, twitches, with any movement or touch to the affected area it intensifies, the temperature rises locally;
• bursitis: inflammation of the bursae due to overload and repeated trauma to the knee. The pains are point, dull, felt at a certain position of the leg after a long load and just as quickly decrease with a change in position. If the process of suppuration begins, then the pains become twitching, edema forms, and the general condition of the patient worsens due to general intoxication;
• tendonitis: the result of overloading the knee joint with excess weight. At first, the pain is mild, aggravated only by pressure, but later becomes constant, occurs when performing light exercises. The range of motion is preserved, but due to a decrease in the strength of the ligament, it may break, which means that mobility will be limited;
• Hoff’s disease: a consequence of chronic injuries that affects adipose tissue. Companion of athletes and older women. The pain is aching, with the development of the disease disturbs the patient at night. The knee feels unstable, the leg seems to give way. If you press on the patella from the side, you can hear a creak and crackle.

Autoimmune diseases

Autoimmune diseases include a large number of pathologies with different clinical manifestations. The main reason for the development of diseases of this group is the production of antibodies against the body’s own healthy ones. That is, in fact, the body is engaged in self-destruction. Without treatment, pathologies of this nature quickly lead to a wheelchair. It can be rheumatoid arthritis, systemic lupus erythematosus, rheumatism, reactive arthritis. All these diseases have characteristic pains and often the root cause of their development is the pathology of other systems and organs of the body. Therefore, in this case, a full examination is necessary.

Degenerative-dystrophic processes

These processes develop as a consequence of the natural aging of the body, and as a result of pathologies of the joint and its surrounding tissues. The soft tissues are affected first. There are many reasons for this group of diseases, but it is difficult to name them during the initial examination. Some cases do not have a “primary source” at all. But they are accompanied by rather unpleasant consequences: osteophytes, calcifications, cysts, knee deformity. If the destruction leads to a decrease in motor function or disability, then the damaged joint is replaced with an endoprosthesis.

Tumors

Benign, malignant neoplasms and cysts of the periarticular tissues and the joint itself are also the cause of pain. Sometimes pain in the knee can serve as a signal for the development of organ cancer. The tumor compresses the blood vessels and nerve endings, which causes not only pain, but also numbness.

Benign neoplasms, as a rule, develop for a long time and slowly, painful sensations are weak, and with the development of large neoplasia, tissue compaction is easily felt.

Malignant neoplasms, on the contrary, are accompanied by an intense pain syndrome. The advanced stages deprive the patient of sleep, and are not eliminated by painkillers.

Open surgeries and manipulations

In the numerous list of causes of knee pain, surgical interventions stand alone. Open operations are quite traumatic and there is a real risk of infection of the wound, which causes the development of inflammatory processes.

Arthroscopy brings much less discomfort. The intervention is referred to as minimally invasive operations, that is, those for which there is no need to make large incisions. For the introduction of instruments, several punctures are enough, which heal quickly and without a trace.

The manipulations include a biopsy – the collection of biomaterial from the joint capsule. After the puncture, a dull and twitching pain is felt, which disappears after a few days.

Psychosomatics

Sometimes pain occurs as a defensive reaction to excessive emotional stress (stress). In this case, the pains do not have a specific character, visible causes and changes, are not associated with physical activity or damage. In weather-sensitive people, pain can occur with a sharp change in weather. “Reflected” pains accompany many diseases of the spine and tend to be reflected from any organs and joints.

Diagnostics

With knee pain, you should contact a surgeon, rheumatologist, traumatologist or orthopedist. After a visual examination, palpation and assessment of the completeness of movements, the doctor prescribes additional diagnostics to confirm the preliminary diagnosis:

• blood test to exclude inflammatory processes;
• x-ray to examine the contours of the joint, the integrity of the bone structures and the detection of cysts;
• ultrasound to detect effusion, loose elements in the joint cavities, pathologies and soft tissue injuries;
• computed tomography and magnetic resonance imaging to detail the changes and extent of damage after trauma, with tumors and inflammation. The procedure is prescribed if other methods did not provide enough information;
• puncture (biopsy) for the study of synovial fluid in case of suspected autoimmune diseases, tumors, degenerative changes in developing inflammatory processes;
• arthroscopy for taking biomaterial for examination, visual examination of the joint and treatment.

Treatment of knee pain

Treatment is prescribed in accordance with the symptoms and the established diagnosis. As a rule, drug therapy first follows, aimed at blocking pain and eliminating inflammatory processes: swollen tissues do not allow for a full diagnosis of the joint. Treatment of symptoms reduces discomfort and improves the quality of life of the patient, therefore it is one of the important components of the complex of medical procedures.

For pain in the knee, warming compresses and massage of the damaged area are prohibited, as they can provoke the development of inflammation, hemorrhage, aggravate damage and accelerate the process of general intoxication. The best solution for a knee injury is rest, a cold compress, and a visit to the doctor.

In the multidisciplinary medical center “Clinic No. 1” you can get a consultation with an orthopedic traumatologist and undergo the necessary diagnostics. You can make an appointment by phone or by filling out the feedback form.

Photo: ru.freepik.com

Author of the article

Bagirov Akshin Beyukovich

Traumatologist-orthopedist, MD.

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How to treat running injuries – blog I Love Supersport

Many are familiar with this bitter bewilderment: I started running, it seemed like I was going to improve my health, but instead pains in my legs begin. Feelings are unpleasant, what to do is not clear. Especially for runners, we wrote an article about why leg injuries happen, what they are and how to treat them. We will run without pain, but with pleasure 🙂

How is the body structured? The concept of tensegrity

To understand what causes running injuries and what to do with them, let’s look at the logic of the approach to the human body in general. For this we need the so-called “concept of tensegrity”.

Tensegrity is a system that is in balance due to the fact that some of the elements are in constant compression, and some are in tension. Elements are interconnected: if you act on one element, all react at once. Changing, the system still strives to maintain its integrity.

For example, a folding tourist tent is just a tensegrity system: the arcs and the fabric of the tent are attached to each other, while the arcs are compressed, and the fabric is stretched. When one element is deformed, the entire structure immediately begins to deform, but it still strives to maintain integrity (read: it does not immediately break).

So, the human body can also be considered as a system of tensegrity: the interconnection of elements, the balance of compression-stretching, the desire to maintain balance and integrity.
Conclusion 1. All elements of the human body are interconnected and in balance.

In tensegrity there are supporting elements and there is something that connects them. In the human body, the support is the bones, and they are connected by muscles, ligaments and tendons. (Ligaments connect bones to each other, and tendons connect muscles to bones.) Some of them are compressed, some are stretched. Thomas Myers writes that there are several “anatomical trains” in the body – muscles, ligaments and tendons that function together and line up in the body one after another, like wagons. They work as a whole: this means that by straining one muscle, we strain the rest of the “train”.

Moreover, almost every effort involves the whole body at once.
Conclusion 2. Tension in any muscle affects at least all adjacent muscles, and at most – the whole body at once.

Let’s move on. Not only does the whole body act as a system and respond to any change within itself, it does not exist in a vacuum by itself: the outside world also influences us.

And the body adapts to external conditions. If you move and strain a lot in life, the body changes in such a way as to endure these loads. If you sit in a chair all day, you get fat and lose mobility. The process of adaptation of the body to the external environment is ongoing, until death.

But the body does not adapt immediately: first it needs to understand that something has changed, then redistribute resources and gradually change in order to adapt to the external environment.
Conclusion 3. The human body adapts to external conditions all the time. Not instantly, but constantly.

Diseases of runners: “pathology of adaptation to stress”

We have just understood the concept of tensegrity and realized that the whole body is a single system that responds entirely to changes in any element and constantly adapts to the external environment. Now, in this light, let’s look at where runner injuries come from and how to deal with them.

All the numerous “sores of runners” can be reduced to one concept: the pathology of adaptation to the load. That is, the body was given a load, and in an attempt to adapt to it, the body suffers.

It is important to understand that in everyday life we ​​also experience stress. It’s just that our body is already adapted to it, and we hardly notice it. But a sharp additional load in the form of running can provoke injuries: the system was already in tension, and this load was the last straw – the tensegrity system could no longer stabilize.

To start running, you need to:

Check with a doctor for a screening
Have your doctor tell you if you have any imbalances and diseases that can worsen with exercise. If yes, how to correct them.

Gradually increase the load
The body needs time to adapt to the load: to realize it, to understand that it is not one-time, and gradually get used to it. And if you sharply overstrain, the system will not have time to adapt and “break”, there will be injuries.

Prevent injury
Warm up well before strenuous exercise, make running shoes if necessary: ​​many injuries are caused by incorrect foot position.

Do physical training
Exercise develops muscles, they adapt to the load and injuries occur much less frequently. Here is a video with the most useful exercises for runners.

Let’s now look at the most common injuries in detail: where it hurts, what it is, why it hurts and how we will treat it.

Spoiler: the essence of the treatment of almost any injury is to first relax the entire “chain”, all the muscles involved in the movement.

Pain on the outside of the knee

A very common injury is the so-called “runner’s knee”, medically known as chondromalacia. The femoral muscle, contracting from tension, pulls on a thin junction in the knee – pain occurs. It usually happens if you have problems with your back or feet and if you train not warm enough.

How to treat: relax the muscles of the whole leg. We do a deep muscle massage – with fingers or a roller. In place of the pain, we glue a patch with an anti-inflammatory. Internally, you can drink anti-inflammatory pills in small courses, but it is better to consult a doctor before doing this. Kinesio tapes also help a lot – watch the video on how to glue them.

Pain on the inside of the knee

The same “runner’s knee”, only on the other side – it hurts not the adductor muscle (as in the previous case), but the adductor muscle.

How to treat: the same. Deep massage of the adductor muscles of the thigh with fingers or a roller. Locally – a patch with anti-inflammatory, kinesio tapes.

Pain in the Achilles region (back heel) or under the knee

Achilles tendon passes into the calf muscle: it hurts when we put a load on the clogged calf muscle. “It breaks where it is thin”, that is, the greatest stress occurs in the thin place where the tendon passes into the muscle. The same story is under the knee – where the calf muscle is attached to the knee.

How to treat: again, we deeply massage the muscles of the entire chain, relieve inflammation with patches or tablets, dose the load.

Pain on the side of the foot, in the area of ​​the bone

On the inside or outside, often with swelling. Most often it happens in people who are just starting to run or switch from one technique to another: they start running on the forefoot, but out of habit they push off with their toes. The muscles that control the toes are overstressed and clogged with lactic acid. Edema appears.

How to treat: kinesiotape, compression underwear (medium compression, walk 3-4 hours after training), lymphatic drainage massage.

Heel pain

This is a heel spur or plantar fasciitis. It is especially painful to walk the first few steps in the morning.

How to treat: we massage the entire chain, especially the calf muscle. Local treatment – soft orthopedic Full-Contact insoles, shock wave therapy 3-4 sessions once a week, put on night orthoses on the ankle at night. If there is excess weight, it is advisable to lose some weight (excess weight puts a lot of pressure on the fascia). We run only if getting up in the morning no longer hurts.

Pain in a tucked leg

Tucked legs if the muscles responsible for balancing the foot are weak. You can check it this way: stand on one leg and see how stable you are. If you are not very stable on one leg, most likely, the stabilizer muscles are not developed – there is a big risk of twisting your leg.

How to treat: prevention – stand barefoot on one leg, starting from a minute and a half, then – on one leg with eyes closed, then – on an unstable platform. If you still sprained your leg, immediately after the injury we do the RICE complex: rest (rest), ice (ice), pressure (compression), elevation (elevation). That is: stop loading, apply cold, squeeze and lift. In general, the RICE complex is the first aid for most injuries.

Pain in the knee

If the knee joint itself hurts from the inside, if the pain is sharp, shooting, if it does not calm down with exertion, this can be a serious injury.