cyclist - burning pain inner thighs & hamstrings

[Diilan]

Hello,
Can I just say that the below statement is partially untrue..

If psoas was going to refer pain, it wouldn't be referring it to the inside of the leg, it would refer it down the front (femoral nerve route). The femoral nerve passes through this muscle, and therefore if this was going to be problematic I would expect a different pattern of pain than to the medial knee.

Well some of it is true but not all... eg I'm not going to go into much detail but I really think you should look closer at your anatomy and the 'innervation' of the BRANCHES of the femoral nerve. I then think your going to wish you never wrote that statement.

I know this is true as I have a medial knee issue caused by a pinching of the femoral nerve (look at branches of this nerve, and dermatomes), this in turn is causing a loss of 'full' innervation to the VMO, my VMO is a little atrophyed, hence medial knee pain...

Solution: TPT.com bought the kit, do the exercises for Psoas etc and things are much better.

May I suggest in future that you research better before making sweeping statements

Good thread though

[Ironmike]

Hello,
Can I just say that the below statement is partially untrue..

If psoas was going to refer pain, it wouldn't be referring it to the inside of the leg, it would refer it down the front (femoral nerve route). The femoral nerve passes through this muscle, and therefore if this was going to be problematic I would expect a different pattern of pain than to the medial knee.

Well some of it is true but not all... eg I'm not going to go into much detail but I really think you should look closer at your anatomy and the 'innervation' of the BRANCHES of the femoral nerve. I then think your going to wish you never wrote that statement.

I know this is true as I have a medial knee issue caused by a pinching of the femoral nerve (look at branches of this nerve, and dermatomes), this in turn is causing a loss of 'full' innervation to the VMO, my VMO is a little atrophyed, hence medial knee pain...

Solution: TPT.com bought the kit, do the exercises for Psoas etc and things are much better.

May I suggest in future that you research better before making sweeping statements

Good thread though

I'm not sure if you intended to come across as arrogant and condescending, but well done anyway.

I stand 100% by my statement that psoas will refer pain to the front of the thigh - go google it or look it up in the textbooks. The original poster's presenting complaint amongst others was that "stretching resulted in burning pain in BOTH medial knees, and in backs of knees & hamstrings." So, you're not thinking hang on a minute, this sounds like there is neurological involvement? Did the original poster complain that he had an atrophied VMO? NO. Did I at any point state that medial knee pain couldn't be caused by a weak VMO? NO. Would you suspect that someone who is a very keen cyclist would have weak quads? NO. You have chosen to completely ignore everything that the patient has presented with, and have just seen the words medial knee pain. Oh hang on a minute, I had that once and it was caused by a pinched femoral nerve - that must be what is going on with 100% of people who present with medial knee pain and burning sensations all over the posterior part of their leg. Oh and I'm not going to elaborate with any clinical reasoning or anything silly like that, just go to TPT.com and do psoas stretches etc. Tell you what, whilst we're on anatomy lessons, go look up the innervation of the hamstring muscles. When you have done that, look up where piriformis (muscle) sits and then something called piriformis syndrome. Apply this knowledge to THE PRESENTATION OF YOUR PATIENT, and then tell me why I am wrong to at least suspect that this could be a cause of his pain? Then come back and try to argue that a pinched femoral nerve will lead to burning in the groin, hamstring and all over the back of the knee. But then again, you know this is true because you had knee pain once, and psoas stretching solved it as prescribed by TPT.com who are a worldwide commodity and risk management company. Perhaps their city hedge fund managers frequently suffer from knee problems?

Your post is so badly put together that I am actually starting to think that it is a joke? Sweeping statements? You have grouped the root cause of all knee pain into a slightly de-innervated femoral nerve, and referred your patient to a corporate risk management company for a solution. Where as I have fully explained my thinking and have reached a hypothesis/alternate way of looking at things based on what the patient presented with, you have decided to say ah heck ignore all that nonsense, who cares about the history of presenting complaint, I'm going to get my speech about VMO out for the 101st time.

A final thing, if you are going to seek to patronise someone in order to gain academic high ground, might I suggest in future that your arguments will have more weight to them if you learn some basic grammar, such as the difference between your and you're. As suggested by yourself, I'm off to send the bankers an e-mail about where I can get hold of their infamous psoas stretching exercises - you have really made me smile, thanks.