I’m struggling with some pain in my right quad for several years. It hurts during some of the activities, but not during running or cycling, so I never stopped doing IMs.
1 ortho and 2 PTs were diagnosing some unknown weakness or imbalance that forces me to overwork the quad and prescribed different exercises that didn’t really help.
Suddenly my new general practitioner claimed that it’s a muscle or tendon damage that just doesn’t heal because I keep training and racing.
Interesting idea, I made an appointment with another highly recommended sport PT and in the meanwhile stopped running and cycling completely ( first time in a decade probably), but the first opening is in a month.
Could you throw me some more recommendations on the recovery of potential strain that was left unhealed for years while I’m waiting? Massage? Binding? Reduce walking (I still walk a lot and it hurts when I walk about 0.5/10)?
It hurts when I walk and when I do certain one-legged exercises with a straight leg. For example yoga bicycle.
Also almost every night after about an hour the quad spasms ( I sleep on the stomach so the leg is straight). Standing up and massaging helps and I can fall asleep.
Symptoms fluctuate but annoyingly I cannot really pinpoint them to any increase in activity, even after marathon training blocks, century rides or IMs.It was increasing when I was more stressed, that’s the only thing I noticed. That’s why it’s very different to diagnose.
I don’t remember any acute injury that lead to this more-less chronic condition. I did a crazy downhill marathon several years ago and legs hurt like never before or since. But both quads hurt equally.
It hurts mostly in the middle of the quad in the lateral part. But sometimes I can feel some tenderness all around the thigh, from knee to pelvis.
Interesting. Many Ortho docs rush to imaging, but seems warranted in your case. I’m jumping in the pool, but I’ll let in marinate more. You report no pain with increased load, so a strain seems unlikely.
I’m a physio, not a doctor, but if you’re quitting pain free activities for now I would encourage you to make sure there’s a compelling reason. After all, it’s not a new thing so why give up what you love in the meantime.
Thank you for a free consultation!
I’ll try to go without running or cycling for a couple of weeks more just to see if it changes anything. I have swimming still.
May be if the pain disappears completely, it will tell something.
Joints above and below (knee and hip) are pain free? I would try knee full extension repeats, contract as hard as you can, hold few seconds, repeat. Try to bring on symptoms afterwards. For the hip, I would try flexion repeats. Sit at edge of chair/sofa, lean forward as far as possible, repeat 10-15 reps, again try to replicate pain afterwards.
Joints above and below (knee and hip) are pain free? I would try knee full extension repeats, contract as hard as you can, hold few seconds, repeat. Try to bring on symptoms afterwards. For the hip, I would try flexion repeats. Sit at edge of chair/sofa, lean forward as far as possible, repeat 10-15 reps, again try to replicate pain afterwards.
Sorry, I didn’t get the second one, I’m not sure how to do hip flexion sitting on the edge of a chair, could you elaborate a bit?
For the hip flexion, once seated at the edge of chair/sofa, just lean forward as if reaching/touching the floor with your hands/fingers. Go as far as comfortable each time (10-15), with the likely result that your range improves as you do more. But the test will be what happens to your quad pain.
You didn’t mention hip pain before? This is new, or goes along with the quad pain? Groin pain or lateral on the outside of the hip? You were better after the knee extension exercise, with the quad pain less and the quad felt looser? If better, do more. If bringing on new pain, stop.
You didn’t mention hip pain before? This is new, or goes along with the quad pain? Groin pain or lateral on the outside of the hip? You were better after the knee extension exercise, with the quad pain less and the quad felt looser? If better, do more. If bringing on new pain, stop.
Sorry, got confused. English is not my first language and in my first one there is a word that combines “hip” and “thigh”. No, I don’t have hip pain. I have only one symptom - this abovementioned quad pain. And after the knee extensions it felt better, at least for a while.
Ok, I understand now. If you got some relief after one set after years of pain, I would continue doing them. Play with how many you do at one time. Often a bigger number is better than a smaller number of reps. Multiple times a day. Full extension of the knee, contracting the muscle hard.
Do them especially when you have pain and see if it goes away, and if so, for how long does it stay away and does that correlate to the number you do and how hard you contract the muscle?
Some updates. Full knee extensions help. They elevate pain completely for 5-10 min and overall pain was lower than before (but not completely disappeared).
I did an experiment: ran a half-marathon without any training (it was horrible, but I just wanted to confirm if hard efforts upset the quad more). It actually did get worse for 1-2 days, not by much, but noticeable. Way less then usual soreness in hamstrings and quads
When I walk, I can feel pain more focused above the knee. At night the spasms still happen in the middle of the quad. Full knee extensions still help.
There may be a neurogenic component to this. When you see your next PT, have them rule out…
femoral nerve involvement
your lumbar spine and the actual hip joint. Which, I’m sure would be part of their exam.
And having had this for, you say, a year or two, there likely is some central sensitization occurring…which is typical in these cases. So that would explain why the area is still sensitive.
