Dear Slowtwitch MD: "Numbness" on outside of left leg, below knee - help!

Triathlon Forum
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Dear Slowtwitch MD:

Hoping someone on here has experienced something similar or has an explanation behind what I’m experiencing / advice. Considering going to my GP but, as is more often than not, this will probably just result a barrage of useless exercises / tests until I ultimately get referred to a specialist - hoping to avoid the hassle.

For the past ~2 weeks, seemingly out of nowhere, the left side (i.e. outside) of my left leg below the knee (including my foot) has been afflicted with a continual “numbness.” The feeling is like after you have a cavity filled and the novocaine is mostly worn off but your cheek still feels de-sensitized. There’s certainly feeling, but it’s “muted’ relative every other “normal” part of my body. The feeling of numbness varies depending on location but seems to be most acute for 3-4” directly above the bony bump that sticks out on the outside of the ankle.

Couple notes that may help:

  • I’m otherwise in perfect health & never experienced something like this before
  • The right side (i.e. inside) of my left leg is not impacted / feels perfectly normal
  • There is no pain, just the numbness feeling
  • This has not impacted my training / motor abilities (that I know of / have noticed)
  • The higher up on my leg (toward my knee) the less numbness I have, to the degree that just below the knee my leg feels normal
  • Foot is impacted too – seems to impact my littlest → index toe, but not my big toe
  • The feeling (or lack of feeling) is mildly distracting. At times I can ignore it to concentrate on whatever task is at hand that requires my attention

Anyone experience something similar / able to offer any input? Thanks!

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If you are describing a pattern of worsening symptoms or failure to improve significantly over such a time course, then I suggest you go see your physician. Regardless of the ability of anyone on the internet to name the likely culprit for your symptoms, the underlying cause and potential treatment options require a closer relationship than you will find here. Good luck.

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Thanks for the note - agree with your advice.

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you should be examined by a neurologist, who may run lots of tests. They’re necessary to rule things out.

I had similar symptoms beginning many years ago. It was initially diagnosed as peroneal nerve compression and there’s a nice scar alongside my knee from surgical release. The surgery did nothing for my symptoms, which worsened with time.

Tingling/numbness can stem from a problem anywhere from the exact location all the way up to the nerve root in the spine. It could be a metabolic problem (MS), a kit problem (bad bike fit) or a postural one (laterally tipped or torsioned pelvis) creating compression somewhere.

good luck – hopefully it’s an easy fix.

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It was initially diagnosed as peroneal nerve compression…

This is what immediately jumped to mind and is probably the most likely cause, but that doesn’t mean there can’t be something else going on.

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Do you sit cross legged often, left over right? This can cause nerve compression. Probably not your problem, but start with the simple stuff first.

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I would think mostly spine related. I wouldn’t waste money on tests which is what the entire medical community does and will probably tell you have a “bulging disc” which around 60-80% of people without symptoms have. Plus the tests are guaranteed not to fix you as you can tell by the guy that had surgery done based off test results and experienced no change in symptoms. I’d recommend seeing a PT and getting a mechanical assessment to see if this symptoms is actually mechanical in nature and what you can do to fix it. I’ve had it before and fixed it myself in 2 days. No pain, just numbness toward the foot when running. Hard to tell you what to do in a forum you would need a physical mechanical assessment that is most likely covered by your insurance. With the correct fix, you can fix this yourself in a few days to a couple of weeks. If you would like more details, email me. I see this every day. Usually it’s rapidly reversible.

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What sort of specialist would I see to get this assessed?

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So a “standard” physical therapist should be able to make this assessment? Thanks for the post

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great question. I would search for MDT trained therapists in your area here: http://www.mckenzieinstituteusa.org/ search providers at the top. I’m curious to see what you find out is the issue. Post back once you find something that helps. Good luck.

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Like others Im sure have stated it sounds like peroneal nerve issues. I had similar symptoms after I had a severe knee hyper extension injury where the leg was extremely swollen for days on end which compressed the nerve and lead to the numbness going from just below the outside of my knee down my lower leg to the top of my foot.
Took forever for it to go away but now Im 100%.
Have you had any injuries to the area etc?

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Nope never any injuries in the area. Sounds like exactly what I have - how did it go away? On it’s own? PT? and how long is “forever?”

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It was probably 2 years or so, it just kind of went away slowly. I had some sort of nerve study done to it where they test it with electrodes and they said it was only about 7% of the nerve was firing.
I just thought Id have to live with it and the doc’s provided no other help other than “yup, you have nerve damage.”
Glad it cleared up, it didn’t hurt but was a very strange sensation.

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you should be examined by a neurologist, who may run lots of tests. They’re necessary to rule things out.

I had similar symptoms beginning many years ago. It was initially diagnosed as peroneal nerve compression and there’s a nice scar alongside my knee from surgical release. The surgery did nothing for my symptoms, which worsened with time.

Tingling/numbness can stem from a problem anywhere from the exact location all the way up to the nerve root in the spine. It could be a metabolic problem (MS), a kit problem (bad bike fit) or a postural one (laterally tipped or torsioned pelvis) creating compression somewhere.

good luck – hopefully it’s an easy fix.

The internet doc in me says nerve root in spine or further up neurological. The advice is worth exactly what you paid for it, so start with the neurologist, hopefully rule up further up neurological stuff and then have the neurologist work from base of spine at exit sciatica all the way down past the peroneal/tibial nerve branch to local. That’s what my 2nd neurologist did. The first guy just said, “you’re screwed, you have a brain problem from your head injury during your crash in 2011”, to which I replied, “then, how come I got back enough control in my leg by 2013 to qualify for Kona and now I can’t walk without spasms at the end of 2015 and need crutches”, to which he replied, “you’re just lucky, you’ve had it since 2011”. He said my only option was a lifetime’s supply of anti spasticity drugs…the crazy part is this guy was the peripheral nerve doc saying it was a brain problem…

Soooooo I go to neurologist number 2…this guy is the brain doc and says, “no your symptoms are not really brain related. There appears to be some mechanical aspect that triggers it, so I think it is in the periphery…so let’s do all the test for brain stuff and peripheral stuff and get to the source”.

Fast forward several months and 99.9999% sure it is not brain stuff…just the result of multiple disk ruptures at the base of the spine “duh, I could have told Neuro 1 that”…and here I am 18 months later. Still not resolved, but shuffling along, doing some jogging, no anti spasticity drugs, and a potential path to 100% recovery either with surgery or letting my body heal naturally. I am opting for the latter and being patient.

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Thanks for the commentary Dev, and fingers crossed for you.

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I don’t have much to offer in terms of advice or ideas but it definitely sounds like the sort of thing you should visit your physician for to get a referral onto a specialist. I imagine it’s probably not anything too serious but it sounds worth checking out. Hope it goes okay for you dude!

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Nailed it!! It’s not nerve root compression though because there is no pain. If a mechanical assessment of the spine is negative move locally to the lateral knee/ fib head area for nerve compression. Beware of worsening symptoms as this is a red flag. MDT will figure it out.

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Wanted to provide a quick update for anyone interested. Not too dissimilar from what some in this thread have said, but here goes:

About a week after the OP I went to see an orthopedist regarding my condition. I visited this orthopedist in the past (operated on my shoulder in the past & helped me with a knee injury) and am a big advocate - knowledgeable and straight-forward. He said that my symptoms were reasonably common (saw patients with similar symptoms often) and that they were generally caused by an impingement or compression in the lower back. He said over time it could go away on its own, but recommended I get an MRI of my lower back and electromyogram (EMG) so he could make a more informed recommendation. I ended up having neither tests administered as a family emergency required my attention for the better part of a month. Throughout this time the numbness began to dissipate, so I decided to put a hold on the tests. I’m now ~3 months from when the symptoms were at their worst and while I still have some mild numbness it’s not enough to impact my daily life. Somewhere during that time I asked my orthopedist if I should get the tests anyway and he said as long as the symptoms aren’t bothering me not to worry about it. Taking his advice (unless things change for the worse).

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Was any of it attributed to training?

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Not that I’m aware of. And ramping back up training does not seem to have an adverse detriment.