Login required to started new threads

Login required to post replies

Prev Next
Re: Fibular Head Pain [rroof] [ In reply to ]
Quote | Reply
rroof wrote:
In Reply To:
In Reply To:
pain at the head of the fibula without traumatic insult is almost always insertional IT band syndrome,


Maybe I am misunderstanding the anatomy (very possible) but I thought that the IT did not actually connect to the head of fibula.


You are correct, it does not (being vague about lateral knee pain, but Gerdy's tubercle to the lateral femoral condyle vs. head of the fibula isn't very clear to most athletes). But in general in a runner or cyclist, lateral knee pain in itself *is* ITB syndrome until proven otherwise. If you are sure it is the head of the fibula only, that would be more unusual with your description (pain off weightbearing, burning, etc.) since the tendinous insertions there should hurt with use instead as was mentioned.

I agree with the doc here.. the ITB could share some fascia alittle more distal and lateral as well but I agree Fib head is not where the anatomy books will have the insertion pointing...I suffered this myself and as someone who teaches this for a living actually thought it was fibular head too when it was infact Gerdy's Tub.... but to think outside of the box it could also be some neural tension or a glute min trigger point could also refer to this area.

If we had to go with odds with out a physical exam I would say hip problem causing ITB issues. Which if this is the case your going to have some work ahead of you before start feeling a whole lot better and it is going to be hard to hold onto all of that hard earned fitness as this takes some healing time and some rehab time.



Dynamic Athlete ProgrammingVIP Endurance Racing | Like us on Facebook Get Your Training Plan Here
Quote Reply
Re: Fibular Head Pain [JayGee] [ In reply to ]
Quote | Reply
This was very helpful. Thank you. I have had identical pain and learned by accident some time ago that nerve flossing helped. During routine stretches, I decided to stretch my hamstrings to the limit with the knee at 0 degrees and toes pulled back all the way. As the nerve was presumably freed, instantaneously the pain subsided. I've since made more progress with the same stretching, in addition to plenty of rest and hamstring strengthening exercises.

Do you have any links to your taping routine? I've found tape very helpful with ITBS in the past.

~~~~~~~~~~~~~~~~~~~~~~~~~~
Speed Concept 9 (race)
Madone 5 (training)
Trek 1000 (rain/snow/sleet/monsoon)
Quote Reply
Re: Fibular Head Pain [saking] [ In reply to ]
Quote | Reply
Muscles far from the knee can often cause pain there. The TFL and glutes connect to and form the ITB. While stretching the ITB can consequently stretch the TFL and glutes, dedicated stretching of those muscles will relieve stress on the ITB. Similarly, stretching the psoas will relieve stress down the leg.

~~~~~~~~~~~~~~~~~~~~~~~~~~
Speed Concept 9 (race)
Madone 5 (training)
Trek 1000 (rain/snow/sleet/monsoon)
Quote Reply
Re: Fibular Head Pain [JayGee] [ In reply to ]
Quote | Reply
Hi JayGee,

Looks like I have the same issue as you had - subluxation of the proximal fibular head. I am dealing with it for 5 years already. I read your post a while ago and started to do hamstring strengthening exercises and stretching my peroneal nerve.. Did you ever get rid of this problem. My fibula is still loose and moving, clicking and snapping. It is problematic, nothing seems to really help. Did you ever heard of prolotherapy ... I heard it could help but don't know much about it.
Quote Reply
Re: Fibular Head Pain [abiks] [ In reply to ]
Quote | Reply
I am both a Physician and patient! I have in the past had pain over my fibular head and was misdiagnosed for years! I felt severe pain after training and also i sometimes felt like my needed to "crack" and then i wound feel a crack and immediate relief. I imagine this was the fibular relocating. I have since taken up jiu jitus and this clinched the diagnosis! I had my fibular head dislocate! and now it continues to dislocated. I saw 4 ortho's who told me it was likely meniscus! and then i saw one doctor for professional football team who told me it was my fibular head dislocating and it was very rare.
i do not think it is very rare, i only think it is very rare that it is diagnosed as it is not taught! Also the treatment is very limited as it is something ortho are not used to diagnosing.

Has anyone here found a solution?

Has anyone tried Prolotherapy? Strapping?
Quote Reply
Re: Fibular Head Pain [noodlehead] [ In reply to ]
Quote | Reply
This is interesting as I have similar pain to the original post. It started a few days after a long training period and has been preventing me from running much further than a mile for just over a year now. At first I though it was IT band, but symptomatically things didn't add up. The pain is electrifying and sharp and occurs from any kind of extended use including running, walking 10+ miles, and tennis, but strangely enough the worst of the pain never occurs when biking. If I land on that knee too hard, that triggers it too. I've noticed that when it is aggravated, it feels tender when I palpate behind the head of the fibula. So it seems to have something to do with the tissues around or attaching to the fibular head. No hip problems, no ankle flexion limitations. Knee has full range of motion with or without the pain present. It's frustrating. I've tried a lot of things including rest, ice, therapeutic ultrasound, voodoo floss, more stretching, as well has taking every joint supplement known for several months (type II collagen, chondroitin sulfate, hyaluronic acid, glucosamine, and MSM). Occasionally it will feel like it's better and I'll ease myself into running again thinking it's okay, but it always comes back. I can't find any concrete answers anywhere on how I can get it to recover faster or info on whether it ever will. I'd love to run long distances again, but I can't run through this kind of pain. Ugh!
Quote Reply
Re: Fibular Head Pain [greenfish] [ In reply to ]
Quote | Reply
Could be several factors at play

1) You're trying too many things and it gets irritated. I see this all the time. Patient along with the clinician throw the kitchen sink at the site of pain with no avail, only to irritate the condition.

2) The problem and site of pain are likely different. Find a clinician who does a thorough ( and I mean 60-75 minute) evaluation. Several other things could be stressing your lateral knee.

3) Your return to activity should be SLOWLY progressed.

CB
Physical Therapist/Endurance Coach
http://www.cadencept.net
Quote Reply
Re: Fibular Head Pain [greenfish] [ In reply to ]
Quote | Reply
@greenfish – First a disclaimer that I am not a doctor neither therapist, but I can give you my experience with an injury that seems very similar to what you are describing. I experienced the same symptoms, I didn’t even need to run it was enough just walking for the pain in my fibula area to develop. My symptoms started in 2009 after meniscus tear injury. After recovery I started with exercises and to my surprise this pain in my fibula area appeared for the first time. It stayed with me for about 6 years. I have seen countless number of doctors and nobody with similar symptoms. Eventually, I ended up in Mass General in Boston where they told me my fibula attachment is loose. I could have done a surgery to tight in fibula, but such type of treatment was suggested if I do a lot of sports. I guess there was no guaranties with a surgery. I like sports however I was never professional, but as I mentioned, in my case this problem was many times in a way of my usual daily activities, forget professional sports. In anyway, I started hamstring strengthening exercises and also stretching of IT band (peroneal nerve area) which helped me. After all this time and for about a year now I didn’t experience problems, but as I mentioned the most I run is 5 miles. I concluded my research with assumption that subflexion of fibula is irritating peroneal nerve that is in close proximity, thus the pain. I hope this helps you somewhat.
Quote Reply
Re: Fibular Head Pain [PTinAZ] [ In reply to ]
Quote | Reply
PTinAZ wrote:
Could be several factors at play

1) You're trying too many things and it gets irritated. I see this all the time. Patient along with the clinician throw the kitchen sink at the site of pain with no avail, only to irritate the condition.

2) The problem and site of pain are likely different. Find a clinician who does a thorough ( and I mean 60-75 minute) evaluation. Several other things could be stressing your lateral knee.

3) Your return to activity should be SLOWLY progressed.

I would echo this and add to make sure during the evaluation they assess the same side ankle joint.

Formerly DrD
Quote Reply
Re: Fibular Head Pain [greenfish] [ In reply to ]
Quote | Reply
I had the same issue last year.

Physio prescribed itb issue. No amount of work or needling made a bit of difference.

Fixed when i went to a new physio who found my Biceps Femoris was tight as fck with a heap of knots in it. Lots of needling, on it then off to the chiro for some adjustments and some self adjustment as mine wasn't dislocation but just becoming very tight so I was helping loosen the area up and slid better. Google the movement required to help free the joint up there is plenty on YouTube.

Sitting on a ball on the bench at home and rolling it up and down the biceps femoris helps alot too.
Quote Reply
Re: Fibular Head Pain [brownmiester] [ In reply to ]
Quote | Reply
I've been in PT practice 20 years and honestly have only seen one subluxing fibular head. I think it's pretty rare clinically.

CB
Physical Therapist/Endurance Coach
http://www.cadencept.net
Quote Reply
Re: Fibular Head Pain [abiks] [ In reply to ]
Quote | Reply
That does sound plausible. I have deliberately held back on seeking any treatment because I know just from the literature and opinions out there that this is not textbook pain. I think with the lack of swelling, bruising, limitations in mobility and acute injury, as well as with the electrifying pain, it does seen nerve related.
Quote Reply
Re: Fibular Head Pain [noodlehead] [ In reply to ]
Quote | Reply
I moved back in July from western NC in the mountains to Nampa, ID. I take it from the elevation drop, I was feeling really good when I would run and bike, so I did a lot of it. Probably should have taken into account overuse injuries. I have had the same problem in my right leg. Pain that feels to be on the fibular head. I have a lot of experience with therapeutic massage, and have found the muscles in between the tibia and fibula to be extremely tight, but oddly enough not painful, so I have been massaging that area with fingers only. I don't believe in putting hard pressure with an arm on a small group of muscles that needs close, localized care.

Anyways, I noticed sometime in September that the fibular head only on my right leg would hurt when I would run. At first it wasn't much. I would have to run 10-15 minutes before I noticed it. And it was only every once in a while. As the weeks went on, I started noticing it sooner and sooner, around the 5 minute mark. I couldn't run for 5 minutes before the pain started. When I was biking, I would feel fine there. So I stopped the running, and started stretching more (I confess I was not stretching everyday like a good runner should to take care of his body), and was only biking for a couple of weeks, and then I started to notice the same pain near the end of my biking- standard road bike- feels like it does most of the work for you compared to a mountain bike. This pain was dull a few weeks prior, but getting into the end of September, it became a little sharper. Now, I've had a stress fracture in my right leg before, back in 2011 when I used to run cross country and track in college. Took time off for about 19 weeks, and did some physical therapy, necessitated by the athletic trainers at my college. At the time I had to deal with my coach telling me he thought I was faking it. He can suck it because that kind of pain is not something you can fake. He ended up getting fired later in the track season, and thank god. But, that is beside the point. I have also had a hip flexor strain in my right hip flexors (the groin area) when I was a senior in high school in April-May of 2009. The athletic trainer at my high school told me to stop training immediately, or else it could tear and get worse. I stopped running for about 8 weeks or so, never went to state in anything that year, but that's ok, better safe than sorry. The trainer did have me do some pt exercises for a couple of weeks.

Continuing on, the trainers I had in college said I had the hip of a 60 year old, and that was when I was 21 (right hip) because he said it would hardly move. He also said my right hip was impinged. I don't know what that means, but I wanted to heal and ease my way back into being competitive again. I also had another athletic trainer start me on physical therapy for my calves (both sides) with one of those blue rubber bands, the long ones, and he had me doing some weird exercises where I'm sitting or standing and I rotate my foot inwards a certain number of times. And I also had the issue with my right toe where the sesmoids were inflamed, so the trainers had me pick up small rocks for physical therapy to strengthen some of the muscles in there, and ice bath, or rub an ice cup on that particular spot. These were all at the same time when in 2011 (not the hip flexor strain though).

So, there's my injury history. I do have to go to the chiropractor once a month now, because in 2013, I joined the army, and since getting out my back has been absolutely horrible. And when I was doing a lot of running and biking, I needed to go in more frequently, about once every 2-3 weeks. My back goes out of alignment pretty quickly. So, in about August of 2017, I started working out again, as I hadn't been for the past few months prior to then. With work and everything, I just couldn't find time until after I moved. I was biking about 15-20 miles in one workout, which would last me about 50-60 minutes, and some days I would do a shorter bike workout and run for 15-20, sometimes 30 minutes. I guess I was doing too much because the pain started up. I stopped working out for two weeks in October, because I got a concussion at work late in September, and that's how I knew that when the pain came back in October that it was something pretty serious, what with my history, I figured I needed to think about what it might be. And then oddly enough, after I stopped working out, I noticed after a couple of weeks, the pain went away. I got a new job in December of 2017, and it requires a lot of lifting on the job, and I would notice that the pain would come back in the same spot anytime I was carrying anything that put more weight on my legs. We're not talking about 1-2 lbs, this was heavy stuff I had to lift at work, up to 100 lbs sometimes. So I told my boss, my work started a work comp thing, because no doubt work contributed to it at least partially, and was keeping it from healing. I am not able to work for what the doctors have said will be three months, now, so back to work I go in March. I'm having a doctor take a look at it this upcoming week (1/17/18)- that is the soonest appointment I could get here, but I know the physician really well already (family friend), and he's let me know that he'll get my work comp. pushed out farther if there is anything like pt that will push back the recovery time so that I don't exacerbate it by returning to work too soon.

Anyway, I'm wondering if anyone has any ideas on this. I've heard the things about IT band syndrome. That's a little too high for it to be ITBS. Any doctor who says otherwise is just implying he wants you to get another opinion (someone who will actually listen to you). All I hear when a doc says that is, "I am incompetent." So. I've heard it could be compartment syndrome, or the fibular head not being in the right position and pinching on a nerve. Sounds great. Just hoping it won't require surgery. If so, VA here I come, hopefully with a referral to somewhere outside the VA, but I won't get my hopes up.
Quote Reply
Re: Fibular Head Pain [Jim Martin] [ In reply to ]
Quote | Reply
I have been going through this same thing.
Lateral
Knee pain. MRI was negative. Was told it was ITB tendonitis. I know it’s not. I’m a physical therapist and know that that’s not what this is.
I’ve had it now for two months and haven’t been able to run.
I just had a cortisone injection last week but it didn’t make much of a difference.
Taping helps a little but not with running. Nothing helps decrease the running pain. I’ve taken 6 weeks off of running.
Biking and swimming are painfree.
Quote Reply
Re: Fibular Head Pain [brownmiester] [ In reply to ]
Quote | Reply
Any resolution in symptoms for you?
Quote Reply

Prev Next