Expert: Dr. J. Shawn Leatherman - 8/2/2009

Question
I am a 26yr old female and am very active in running and cycling. Recently I started trail running, which has been the only change in my activities. I also work at a hospital as a nurses assistant where I am on my feet for 12 hrs a day/3 days a week. Yesterday when I woke up in the morning and was putting lotion on I noticed that my lower left leg from just below my knee to right above my ankle is numb. My foot and toes are not numb and my calf is not numb. There was no blunt trauma to the area nor did I bump it on anything. Should I go see a doctor or wait to see if it goes away? It makes me nervous because I don't want any tissue or nerve damage...do you think if I continued running it would make it worse? It does not hurt when I run, walk, etc...its just numb.

Answer
Dear Stephanie,

Short answer here is yes...go have the area functionally examined, and I would recommend a sports injury trained chiropractic physician for the exam...because functional medicine is what we do, and the medical community will likely blow this off as nothing since you are not showing any serious symptomatology.  You can find such chiropractic physicians at www.acbsp.com.

Now a few things to consider is the repeated and prolonged pressure (walking/running) on the spine could be responsible for irritation to the lumbar nerve roots which supply sensory information to the leg...however, if you have full muscle function in the foot...(can stand on heels and toes interchangeably without problem) the LS and S1 nerve roots are probably fine.  Specifically, the peroneal nerve could be irritated around the knee which supplies sensory information to then lower leg, but not the foot.  This nerev can become irritated with improper foot, ankle or knee mechanics...often fixating the fibular head while walking.  A fixated fibular head can easily irritate the peroneal nerve course...but is easy to correct with simple posterior knee adjustment...the ankle and foot should be addressed as well.

One thing you should immediately consider is your footwear...make sure that the soles are providing support to the foot and that you are not working and running in poor footwear.  The fact remains that this problem may easily arise out of the foot rather than the knee area itself or the low back, and this should not be overlooked.

Lastly as a runner and someone who is on her feet all the time, the ITB (iliotibial band) and TFL (tensor fascia latae)need to be addressed.  This band of fibrous muscular and tendon tissue runs from the lateral hip to the lateral knee and when contracted can be a source of problems.  It is frequently tight and inflamed in runners.  Most common presentation of this is actually lateral knee pain although tingling and numbness can also occur.  The area will be tender to the touch and taut tender fibers may be found as well.  Again stretching protocols and soft tissue work help to correct the problem fairly quickly.

Hope this helps Stephanie.

Respectfully,
Dr. Shawn Leatherman
www.suncoasthealthcare.net