Pain in upper leg

Area of pain

Area of pain

For over a year now, a have a pain in my right thigh. It is around the hip flexor, to the inside of the leg.


There was no specific injury. One day I started to feel a sensation like a there was a tear in the muscle. It is not very painful. Over the past year, it has worsened, whenever I start working out. It is not very painful but is an ongoing discomfort. I only feel it in certain positions: e.g. lunges or if I stand and bend my leg pulling my foot to my butt.

- I work out about 30 minutes 3 times a week. I do various activities, spinning, group classes, elliptical machine.
- I work in an office, walk 25 minutes two times a day.

I have been to months of treatment – physio, chiro, osteo, massage therapy. Nothing has resolved my issue. I have seen two different doctors more than once. Here are some things that my treatment providers have told me:

- I naturally hold myself in anterior pelvic tilt. I now make a big effort every time I am walking to be in a neutral position.
- One doctor said I had hip bursitis and gave me a cortisone shot which did nothing.
- Scar tissue from an injury (although I don’t know of an injury I have had). I need to keep moving so that the scar tissue comes apart and heals.
- I also have very hard knots in my quads all the time. I do regular rolling. At one point as part of my physio treatment, I was also getting dry needling to release the knots. It did not provide any sort of lasting solution.
- My toe muscles are weak on this leg – in the abductor hallucis area.
- My glute muscles are weak.

Thank you for any advice you have.

Best regards.






Firstly, congratulations for taking the time to spell things out clearly.

Let's start with five tests. Please respond as accurately as possible; only then can I possibily help.

1. Sitting in a kitchen chair with your head flexed on your chest, ask someone to left your left leg parallel to the ground. Now repeat with the naughty leg. Is there a significant difference? Where?

2. Standing raise your left big toe and ask your friend to press down on the toe. Remember how strong it feels. Now repeat with your right big toe. Is there a significant difference. In other words is it actually weak, or only feel weak?

3. With a little oil on your thumb run it down from the ASIS through the groin and down the inner thigh. Are both sides about the same?

4. Let's add a fourth; bend slowly forwards, then backwards, then to the side. Any pain in the back and in particular any radiation or pain in the upper leg?

5. Lying on your back with your hip and knee at 90*, ask your helper to push hard on your knee towards your toes, and you pull your upper leg equally hard towards your chest. Pain? Weak?

Please write down what you feel after each test and reply in detail what you are experiencing.

I take it you've had an x-ray of the pelvis; if not get one, preferably taking standing.

Ask your various doctors if the femoral stretch test and quad reflexes were normal.

Let me know.

Dr Barrie Lewis DC
 

 

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Feb 27, 2018
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by: Cynthia

Hi Dr. B, thank you for your help and all the details. Here are my responses

1.No difference

2. No difference. But if I try to lift my big toe without lifting my other toes on this same foot, it is much more difficult on my bad leg.

3.For my bad leg, there is tenderness when pressed on the groin area.

4. None at at all.

5. Nothing.


No doctor has accepted to send me for an x-ray, said it was not needed but I will ask again.

I will ask about the femoral stretch and quad reflexes tests

Thanks,
Cynthia

Hello Cynthia,
It's certainly not clearcut but I'd hesitate a guess this is not from your back; unless the femoral stretch, quad or medial hamstring reflexes are diminished, or there is real weakness in the big toe.

Your answer in regard to the big toe is not really clear; is it weak, or isn't it. Your doctors should test it; it goes along with the medial hamstring reflex. Prick the area on top of your foot, and the great toe with a needle; any difference right and left?

What this leads us to is that tenderness in the groin; there are muscles there, the pubic bones, the large femoral artery, inguinal hernia and enlarged lymph nodes.

It's not sounding like hip arthritis, but are you very flexible, especially in those hips? Is there any family history of hip dysplasia? That x-ray is important; send me a digital copy to contact.

Let me know when you've had the x-ray, with the report, and the tests I've asked for. Right now nothing is clearcut.

Dr B

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