Peroneal nerve damage

Anyone ever have any problems with this? I have increasing pain at the fibular head and it has been radiating down the outside of my leg. Recently I've been getting pins and needles down the leg and into the top of my foot and two smallest toes. Pain when i push off with my toes (walking/running) or when i lean forward and put weight on the ball of my foot. No pain when standing. No pain when I climb, even when toeing in hard or heel hooking.

Have a team of physios on it and they all think it could be related to a bilateral pars defect in the L4/L5 region (broke it when I was a kid, no surgery). Currently have no back pain, but knee pain is worsening, even with a decrease in activity.

Been trying to strengthen the glutes and hip abductors since I have obvious control issues at the hip. Also doing Williams Flexion exercise for back and routine hamstring stretching, etc. Avoiding weighted flexion of the knee past 90* except when climbing. Nothing is helping. Plan to take a break from climbing after my next trip in Feb.

Seeing a Dr this week who will hopefully refer me to an ortho so I can get some X-rays and MRI. Also haven't ruled out stress fracture of fibula, but all ligaments are fine and the pain is not indicating IT band issues.

Anyone ever deal with this? I can't run or ride. It sucks.

Have you had any surgery recently where you have been positioned on that side? During surgery in the lateral position it is very important to make sure that the bottom leg around the knee area is well padded in order to prevent damage to the peroneal nerve. Any other prolonged inactivity laying on that side?

I'm empathetic regarding your injury or condition, I've had elbow extensor tendonitis for a year now. But, all this self-diagnosis over the internet is really just narcissistic introspection until you go see an orthopedist, good physical therapist, sports med doc, and get the x-rays and MRI.

Day in, day out, I'm confronted by people with:

"Hey, doc, I researched this or that, or the other thing myself on-line, and diagnosed my dog/horse/cat with thus or such. Can you read these 47 pages I printed out and tell me what you think?"

It's all voodoo or speculation until you get the appropriate exams and tests done.

Your symptoms (i.e. nerve pain down the side of the leg, top of the foot) suggest nerve impingement at the lumbar, sacrum. See an orthospine or neurosurgeon.

With radiating nerve pain in the leg, my first thought is always some form of sciatica - it's typically the most common cause....

try loosening the fibia with massage and get it to "rotate" or "float" when relaxed. can take a while but worked for my fibia pain.

Really, it could be a nerve root issue in your spine, a bone stress fracture, tendonitis in your muscles of the leg, or pyriformis syndrome, or something else.

Honestly, I doubt it's your back if it doesnt do it when weight bearing through your spine like when you climb and stand.

Interesting case, sorry your are dealing with this.

On the flip side, if it is your back they will have you do PT to strengthen your abs as a first resort to treat it :D Good Luck.

It's all voodoo or speculation until you get the appropriate exams and tests done.

I'm seeing a Physical Therapist for some Hip pains right now. I have some sacroiliac joint issues from crutching around too much when I had a broken foot which threw my body alignment out of wack. It's not bad compared to what you're experiencing but I've been learning a lot from my PT who also climbs.

Two main options are that you can either do exercises to re-balance your body or you have to get surgery. Best to try yourself first. My PT has been telling me that the hips can get out of alignment and pinch leg nerves when your core is unbalanced (hips are tilted back too much and applies pressure on sacrum and hip joints). This is common among desk job people who sit all day long as well. Many climbers have stronger backs and not as strong abs. Additionally, climbing involves toeing in, which only strengthens the "inward" motion of the hips. This leaves the gluteus medius & minimus disproportionately weak. Building these two muscles of you outer ass up will help balance against your strong inner ass (used toeing in). Activities such as running will only aggravate the hips further.

To rebalance, one can work on the smaller glute muscles mentioned above. A great stretch for this is "Pigeon" and an easy way to strengthen is to have the knees together and apply resistance as you pull them apart (lay on side and lift a knee while the feet remain together - kind of like a sideways one legged butterfly stretch).

A less mainstream approach would be meditating on the first chakra with a focus on awakening the Kundalini Dragon within you. The energy should heal you right as rain.

Keep in mind that surgeons get paid to cut people up and their advice may be slightly bias.

I have had some similar pain. It is a bit different though, mine starts around my sacral or lumbar plexus, then heads down around my anterior thigh and finally down the outside of my lower leg, fibula area. The sensation is the same though, pain, pins and needles. I found that for my pain doing stretches similar to IT band stretches did wonders. The different opinions I came across was that my sciatic nerve was short or running through my piriformis muscle. Both are common. I would try and find some stretches that stretch the muscles/area that you are experiencing pain in. Worth a try at least.

TWK wrote:It's all voodoo or speculation until you get the appropriate exams and tests done.

Thanks for all the replies. I'll go through them a bit more carefully when I have some time.

I am not really "self" diagnosing and certainly not putting to much faith in the internet, but I know there are smart people here and I thought I'd see in anyone had any experience.

My parents are both PTs and have been helping me rehab and stay in shape since I broke the bone in my back 14 years ago. That was horrible - so I have actually done core work and Williams Flexion off and on since then as a preventative measure. And I've had hip problems in the past that cause me to do the glute and abduction strengthening, so I'm really only doing exercises now that are part of my routine anyway. I also have had a few massage sessions and one acupuncture from a local physio.

But in the last few weeks the symptoms are pointing to something that needs to be treated by an ortho and can only be confirmed with an MRI so I made a Dr appt. Between my parents and the local guys And now a Dr I think I am doing a pretty good job of NOT self diagnosing, but you must understand that it helps to find others who have overcome similar issues.

Not being able to run or walk without pain is bad enough, but for the cause to be unknown and not from an injury, it's kind of scary. All I am looking for on MP is something to lighten the mood, not a diagnosis.

Peteoria wrote: To rebalance, one can work on the smaller glute muscles mentioned above. A great stretch for this is "Pigeon" and an easy way to strengthen is to have the knees together and apply resistance as you pull them apart (lay on side and lift a knee while the feet remain together - kind of like a sideways one legged butterfly stretch). A less mainstream approach would be meditating on the first chakra with a focus on awakening the Kundalini Dragon within you. The energy should heal you right as rain. Keep in mind that surgeons get paid to cut people up and their advice may be slightly bias.

Interestingly enough, I was doing that butterfly excercise while I read your post on my phone. I use red theraband tied around my knees. I have also been doing pigeon too as part of a big stretch routine I do at night.

It's worth mentioning that I thought this was an IT band issue when the pain started (August). But at that point it was a sharp pain and only occured when I ran more than a few miles. But after I stopped running, stopped cycling to work and started some glute strengthening excercises, it didnt get better. And now that I've been examined and ruled that out it's getting scary. The pins and needles is new(January) and it is freaking me out. It's going off right now and all I'm doing is sitting.

Whether weekness in the outer glutes is causing this or not, I have weakness there so I figure I can continue on with the excercises anyway, as well as the core strengthening. None of it agrivates the knee.

I dunno about getting in touch with my inner Komodo Dragon but I guess it is worth a shot if nothing else works. I am NOT interested in having surgury unless it is completely obvious that it is the only option. Believe me, growing up in a family of physios, I hear all the time about how many people get sliced open prematurely.

I will se a doc his week but it will be next week before I ses a specialist and who knows how long before I get an MRI. Gotta love National Healthcare. America is next - beware. ;-)

Ryan Williams wrote: I will se a doc his week but it will be next week before I ses a specialist and who knows how long before I get an MRI. Gotta love National Healthcare. America is next - beware. ;-)

Yeah, I had my knee MRIed in 2004.

I still haven't gotten the report, although I'm certain the hospital got their money for my visit from my insurance company (who puts my tit in a wringer every paycheck), the hospital gave most of their fee to their lawyers for their insurance, sent half of what was left to the MRI manufacturer, who in turn sent half of that to their liability carrier.

Our current private carrier health care system MUST be working great, because in the meantime, my knee fixed itself after I chucked my Nikes and started running in Five Fingers.

TWK wrote: Yeah, I had my knee MRIed in 2004. I still haven't gotten the report, although I'm certain the hospital got their money for my visit from my insurance company (who puts my tit in a wringer every paycheck), the hospital gave most of their fee to their lawyers for their insurance, sent half of what was left to the MRI manufacturer, who in turn sent half of that to their liability carrier. Our current private carrier health care system MUST be working great, because in the meantime, my knee fixed itself after I chucked my Nikes and started running in Five Fingers.

Hahaha, yea I hear ya. I don't think there are any healthcare systems out there that work as well as we'd like. As you can see from my previous posts, my parents are both in the healthcare industry (in the US). They are not very happy w/ the way things have been since, I dunno, forever.

This will be my first real experience w/ the NHS and I shouldn't complain yet. I pay about the same out of my paycheck that I would if I was on a personal health plan in the US, except here there are no hidden costs, no deductibles, nothing. If the quality of care is reasonable then I'll be happy, but I'm sort of prepared for the worst.

Ryan Williams wrote: Hahaha, yea I hear ya. I don't think there are any healthcare systems out there that work as well as we'd like. As you can see from my previous posts, my parents are both in the healthcare industry (in the US). They are not very happy w/ the way things have been since, I dunno, forever. This will be my first real experience w/ the NHS and I shouldn't complain yet. I pay about the same out of my paycheck that I would if I was on a personal health plan in the US, except here there are no hidden costs, no deductibles, nothing. If the quality of care is reasonable then I'll be happy, but I'm sort of prepared for the worst.

Well, I'll be curious to hear how it goes. PM me, or post here again with updates.
Good luck!

You get it fixed ?