Sciatic nerve pain behind the knee
 

Hi, I've had a pain at the back of the knee, just where it folds when bending. I'm into running, triathlon and cycling and have had the pain for about 8 months. Basically if I do any type of excerise it flares up with a bit of swelling behind the knee. I've had an MRI, Ultra sound and X-ray and all have come back clear. Physio and specialist say it may be a tight or inflammed sciatic nerve, but they can not be sure. I'm 34 and at the time of injury I was about 200lbs, it became sore while running.

I've do a stretch were I sit on a table, put chin on chest and raise the left leg straightening at the knee. Left (sore) leg can not stretch as far as the right. Also when the left leg is straightened and the toes pointed back again it does not have the range of motion as the right (good) leg.

It tends to be tender sore first thing in the morning but will subside after 15-20mins once it has "warmed-up". Then if I do any type of excerise like 10mins on bike it gets sore about an hour or two after finishing. I can do weights on it with no pain. Basically if I don't do anything I can cope with it but with any type of excerise it gets pretty sore.

Can anyone help please.

eMedicine article on Iliotibial Band Syndrome - sounds most likely
eMedicine article on PCL injuries
eMedicine article on plical irritation
eMedicine article on patellofemoral syndrome - most common anterior knee pain cause ever
These are a couple of thoughts... I'm not an expert by any stretch, but I'd be surprised if it were sciatic pain. Sciatica doesn't feel better after "warming up". Some people feel better after stretching, sure, but hopping on a bike for a bit? No. Typical presentations of sciatic pain are shooting pains down the legs, butt pain, etc. Not isolated knee pain.

I'd be getting second opinions, and from as swanky a hospital as I could find. Where are you located? I might be able to point you in the direction of awesome orthopaedic doctors.

Hi there Jess. I'm situated in Belfast.

Well, this is England, but this is the hospital that HSS (www.hss.edu) is helping to put on the right track for Orthopaedics: http://www.mercuryhealth.co.uk/index.php?id=20

Beacon Hospital is associated with Johns Hopkins, who are great with ortho.

That's all I could find for any of the ones that I know.

Cheers for that JJ.

I've just made an appointment to see a neuromuscular specialist. I'm so frustrated, I just wanna get back to training and racing and with a new season only weeks away it just makes it worse.

If it is sciatica a chiropractor can help. Your spine takes quite a pounding with all your are doing and compresses over time. Other things can happen as well. It's usually a vertebrea pressing on a nerve. Get those lined up sort of like the front end on your car and the wheels will turn smoothly.

I've been where youare with this and that was the magic lesson after several bouts with doctors!

Chiropractors can also make it worse. It's not usually the vertebra pressing on the nerve, it's the disc.

Anyone can make a situation worse... just ask all the people that get screwed up by doctors. More people are killed in hospitals every year due to mistakes than were killed in the entire Viet-Nam conflict. You have to find a chiro that is good. We could begin a new thread just on that subject but asking around usually works.

And usually the disk is pressing on a nerve because the vertebrae is pressing on the disk and so on and so forth. This all works together as the disks cushion the vertabrae. A problem with a disk is because the vertebrae are out of line, usually caused by injury or repeated muscle spasms pulling them out of line. It would be unusual for something external to target a disk. Hope that all makes sense.

I really got into how this works as a result of problems I had yeas ago.

I had to get surgery because of a herniated disk pressed so hard against my spine that I could not walk because of scaiatic nerve pressure.

It's a weird sort of pain. I knew that there was NOTHING wrong with my leg, that the pain was all but mental, and even pressing my foot on the ground added no pain because the pain was constant. However, I could not put any pressure on my left leg because my brain would not let me. Although there was no more pain when putting pressure on my leg than there was without, my brain would not let me take a step with what would otherwise be a perfectly healthy leg.

http://www.audreysmassage.com/images...ior%20View.gif
Yeah, look at the size of the thing. It's HUGE. It becomes the peroneal nerve around your knee. This is why it hurts so damned badly.

thingstodo: Understood, but I really wouldn't want a chiro messing with my alignment if the doctors didn't see anything unusual on MRIs, Xrays, and Ultrasounds. Disc problems aren't just due to simple alignment issues - trauma, repetitive movements, strain... can cause issues with the disc, thus the sciatic nerve.

Seaver: I bet you couldn't move your leg because with the disc pressing so hard on the nerve, messages couldn't get to the muscles of your leg to tell them to contract and move your leg. And that sounds *awful*, by the way. Glad you're doing better.

Updates, Brian?

Your call. They didn't see anything on mine either but still wanted to cut. That was a long time ago and I'm great today. I get adjusted every three months and stay ahead of potential problems now. I moved one time and didn't get a new chiro... and a year later I was back. They literally saved my life!

But wouldn't you rather get physical therapy and learn how to not need a treatment every 3 months?

/end threadjack, sorry

Its about setting your expectations - and being realistic.

I did get PT and learn about stretching. In fact, my wife is a very good yoga instructor and she even gets adjusted every 2-3 months. It's also about the fact that your spine can still get out of alignment for a variety of reasons including the aging process (that effects EVERYone) and getting adjusted ahead of feeling symptoms keeps things working much better.

Just getting PT and learning isn't enough. In fact, the more I learned, the more I understood the whole process and realized all the different things (in addition to chiro) I could do to be proactive. I know a hell of a lot more about anatomy and especially the mechanics of spine than I ever thought I'd know.

Another option for adjustments is a Dr. that is a D. O., my family Dr. is a D.O., I love that he can handle both medications & adjustments...actually him giving me adjustments has helped me avoid many a medication!

Funny you should say that. My wife, while looking for an MD that also practiced holistic methods, found one that is also an MD/ DO. He adjusted her and now I've recently switched from my chiropractor and my MD to this guy.

He is great because he has a toolbox with many tools to chose from, rather than just one specialty!

Brian,

Did you ever find a resolution to this? I have had this exact problem for 3 years. I've been to a million docs and I still have the burning pain behind my knee, and back of calf too.

Thanks!

Karen

Hey Brian -- I want to educate you about a man named Pete Egoscue.
He is in San Diego area and he can probably give you a new look on this problem.
Google his name, he has written a number of books, the first and most famous is titled
"Pain Free" -- you can also check out his Egocue clinic website.
What he teaches is that the alignment of the body (or the lack of it ) creates a LOT of problems
that can be solved w/out surgery, Rx etc --- but rather through motion.
To me - he transcends Chiro's and what I can tell you is - before you endure another minute of pain,
click onto his web site -- dish into his radio podcast -- You will be helped.
CMC --

Hi Brian - quite interested in this because I've had EXACTLY what you're describing for the past year and a half, I'm also into running, martial arts and hiking...or at least I was because this knee thing is really messing it up. Been to a few different doctors and physio's and have been diagnosed with possible tendonitis or ligament injury but the physio hasn't worked at all. Basically the docs and physio's are totally confused by it. Going to see an orthopaedic consultant and hopefully get ultrasound scans. Did you find a solution yet?