Thigh pain after walking (Femoral nerve trapped?

by B Watling
(Portsmouth UK)

After walking for about half an hour I begin to get a pain down mt left leg which gets more painful the further I walk and then starts to cause a limp in my left leg. It feels like a groin strain but it is not that. If I continue to walk for an hour or two (At an Exhibiton) and then return to my car I cannot lift my left leg into the car. I have to lift it in with my arms causing excruciating pain in my left leg. After around an hour's rest the pain slowly disappears until next time I walk any distance.

I also get the same sypmtoms if I potter around the house and garage all day. I also get at the same time a sort of tingly stinging feeling in my left ankle joint.

I am male, 74 years old, normally very active, returned to UK after 8 years in France where I was walking up to three or four miles a day 3/4 days a week for exercise. I also ride a fast superbike which does subject my back to some hefty painful jolts at times on our poorly maintained roads.

Hello Mr Watling,

The first, an unlikely consideration but needs to be considered. Pain in the leg that increases with walking could be a partially blocked artery in the groin area causing "intermittent claudication". Ever a smoker? High cholesterol? To rule this out you need to ask your doctor to check the posterior tibial artery pulse in the ankle.

More likely, this sounds like a hip condition, or perhaps a referral as you say via the Femoral nerve to the front of the thigh and inner lower leg. A Femoral nerve stretch test will verify this.

Lying on your back pull first the good knee to your chest, then towards the opposite shoulder, then rotate your hip. Now the naughty leg. Is there a marked difference?

What's needed is an X-ray of your hip. In the X-ray above for example, is a condition called Femero Acetabular impingement syndrome that causes these sorts of symptoms, but there are others.

Start with an X-ray.

Let me know what pulling your leg about does.

Dr B

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Feb 09, 2013
Additonal Strech Ideas after your walk.
by: Garry Anderson

Hi Mr. B. Watling:

Thank you for trying my suggestion.

Today, I went for a walk to test what muscles were becoming tight, then when I finished, I tried some stretches to see which ones were most effective. Thus, I would like to suggest you try the following stretches as soon as you feel the problem coming on, for example while you are on a walk:

1. Stand straight with your back against a wall, a fence, or a tree, then slowly bend forward at the waist and stretch down to touch your toes and hold your ankles. Hold this for about 5 seconds, then slowly lift up again. Repeat 5 times. This will stretch your back muscles, mainly Q.L. and other back muscles. This stretch really helped loosen up my back after my walk today.

Careful here, if there is a disc injury, this could make it worse. Listen to your back and leg, they will tell you if this is threatening. Dr B.

2. Sit on a chair or bench with feet on the ground. Left your right leg with ankle on your left knee, then hold your right knee with your right hand. Now, wrap your left arm around your right leg, at the shin, as far as possible. Now, lean your chin and head into you right elbow going as far as you can while pulling your right knee toward your body while you stretch into it. You should feel a stretch in your right buttocks (right gluteal media & piriformis) and your left shoulder and upper back. Hold for 5 seconds, then unwind. Repeat 5 times. After this, swap legs and do the opposite side. This stretch really helped my gluteal & piriformis muscles which had tightened up during the walk. You can see the video by googling "desk stretches for relieving lower back pain at the office".

If this is an impingement syndrome that is causing your groin pain, this MAY hurt right in the hip, but probably not as it's usually internal rotation of the hip that provokes the pain. Dr B.

After these stretches, the tightening after my walk was relieved. You may find they help your condition.

Let me know if any of these ideas help.

Garry Anderson.

Ask your doc to do the Femoral nerve stretch. This will tell you if it's a pinched nerve in the back. Dr B

Feb 07, 2013
Lower leg problem
by: Anonymous

Many thanks for your comments, I tried what you suggested but no difference between my to legs.Have been to Physio, referred by my Doctor but they could find nothing wrong. Have had Xray and that apparently is OK as well.I think after studying various conditions on the net that it is either a partially trapped or restricted artery. I did used to smoke but stopped in 1977.

Hello Mr Watling,
Frankly I have my doubts about the trapped artery. Your doc would certainly have found a diminished or absent pulse behind the ankle. And you stopped smoking a very long time ago.

What you describe is far more likely to be a hip / psoas muscle / irritated Femoral nerve, or branch thereof.

Is it possible to get a copy of your X-ray? Take a photo of it with your digi (no flash) if it's on plain film. Send to contact.

Dr b

Feb 03, 2013
Stretch Your Iliopsoas Muscle Before and After Walking
by: Garry Anderson

Hi Mr. B. Watling:

In respect of your posting, I have some thoughts I would like to share with you, in the hope that they may help you with your situation.

When my symptoms first developed, they were the same as yours, deep pain in the left groin, and weak left knee with swelling and difficulty walking. I, too, had to lift my leg to get it into the car, with any twisting being very painful.

I posted my article about entrapped femoral nerve with a detailed description of my symptoms. When my symptoms first began, they came about by sitting too long, which resulted in the Iliopsoas muscle group becoming tight, thereby pinching the Femoral nerve (both motor and sensory).

In your case, I am thinking that your Iliopsoas muscle may be tightening by walking (like calf muscles, and hamstring muscles, if overused). The fact that you gain relief by resting tends to suggest that your Iliopsoas muscle relaxes and thereby allows the pinched nerve to function normally again.

As you know, it is important to stretch your quadriceps, calf, and hamstring muscles both before and after any long walks. This becomes more important as we get older. However, it is easy to overlook the Iliopsoas muscle because most people don't know it exists, since it is hidden behind the intestines.

In your situation, I would suggest you try stretching the Iliopsoas muscle both before and after walking, to test if it is a contributing factor.

The best stretch I have found is the yoga stretch called "Deep Lunge" with your arms and elbows on the floor. An alternative is the "Pigeon Pose", but that may be difficult on your knees. With your left leg behind you, flat on the floor, and your body arching up and backwards, you stretch the entire Iliopsoas group.

A simpler alternative for stretching the Iliopsoas muscle, is to lie on the edge of a massage table, and let your left leg hang down under gravity, while pulling your right leg toward your chest with your hands behind your right hamstring. The pulling movement forces the pelvis to pull upwards, while the gravity pulls your left leg down and stretches the iliopsoas muscle.

For more information, I suggest you Google the phrase "ILIOPSOAS SYNDROME: THE HIDDEN ROOT OF PAIN" and see what you find.

Best wishes, and let me know what you find.

Garry Anderson in Canada.

Thanks for this Garry, great post.

Mr W: Google "deep lunge" - there are some good Youtube videos.

Dr B

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