Saphenous Nerve Entrapment

with Rehab

ExitCare ImageSaphenous nerve entrapment is a condition of the nervous system in the thigh. The condition is caused by pressure placed on the saphenous nerve by the ligament-like tissue (fascia) and muscles in the thigh. The compression on the nerve causes pain, numbness, and loss of feeling in the lower extremity.

SYMPTOMS

  • Signs of nerve damage, including tingling, numbness, or burning on the inner (medial) side of the knee, inner leg, and occasionally the inner foot.

  • Pain or tenderness on the medial side of the lower extremity.

  • Burning sensation.

  • Pain that increases with activities such as running, jumping, or long walks.

CAUSES

Saphenous nerve entrapment is caused by pressure being placed on the saphenous nerve in the thigh. The pressure is often caused by structures within the thigh, such as fascia, muscles, or other structures. The saphenous nerve begins near the skin and travels deep into leg.

RISK INCREASES WITH:

  • Contact sports (football, rugby, soccer, or lacrosse)

  • Activities that involve repetitive and/or strenuous use of the thigh muscles (running, jumping, or prolonged walking).

  • Improperly fitted or padded protective equipment.

  • Poor strength and flexibility.

  • Overly strong quadriceps and thigh (hamstring) muscles.

PREVENTION

  • Warm up and stretch properly before activity.

  • Allow for adequate recovery between workouts.

  • Maintain physical fitness:

  • Strength, flexibility, and endurance.

  • Cardiovascular fitness.

  • Wear properly fitted and padded protective equipment.

PROGNOSIS

If treated properly, then the symptoms of saphenous nerve entrapment can be resolved. Occasionally, the symptoms resolve spontaneously and sometimes surgery is necessary.

RELATED COMPLICATIONS

Permanent nerve damage, including pain, numbness, tingle, or weakness.

TREATMENT

Treatment initially involves resting from any activities that aggravate your symptoms. The use of ice and medications may help reduce pain and inflammation. The use of strengthening and stretching exercises may help reduce pain with activity. These exercises may be performed at home or with referral to a therapist. Your caregiver may recommend that you receive a corticosteroid injection to help reduce the inflammation that is compressing the nerve. If symptoms persist despite non-surgical (conservative) treatment, then surgery may be recommended. Surgery for this condition involves freeing the compressed nerve from the fascia that is placing pressure on it, and provides relief for most patients.

MEDICATION

  • If pain medication is necessary, then nonsteroidal anti-inflammatory medications, such as aspirin and ibuprofen, or other minor pain relievers, such as acetaminophen, are often recommended.

  • Do not take pain medication for 7 days before surgery.

  • Prescription pain relievers may be given if deemed necessary by your caregiver. Use only as directed and only as much as you need.

  • Corticosteroid injections may be given by your caregiver. These injections should be reserved for the most serious cases, because they may only be given a certain number of times.

HEAT AND COLD

  • Cold treatment (icing) relieves pain and reduces inflammation. Cold treatment should be applied for 10 to 15 minutes every 2 to 3 hours for inflammation and pain and immediately after any activity that aggravates your symptoms. Use ice packs or massage the area with a piece of ice (ice massage).

  • Heat treatment may be used prior to performing the stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or soak the injury in warm water.

SEEK MEDICAL CARE IF:

  • Treatment seems to offer no benefit, or the condition worsens.

  • Any medications produce adverse side effects.

  • Any complications from surgery occur:

  • Pain, numbness, or coldness in the extremity operated upon.

  • Discoloration of the nail beds (they become blue or gray) of the extremity operated upon.

EXERCISES

RANGE OF MOTION (ROM) AND STRETCHING EXERCISES - Saphenous Nerve Entrapment

These exercises may help you when beginning to rehabilitate your injury. Your symptoms may resolve with or without further involvement from your physician, physical therapist or athletic trainer. While completing these exercises, remember:

  • Restoring tissue flexibility helps normal motion to return to the joints. This allows healthier, less painful movement and activity.

  • An effective stretch should be held for at least 30 seconds.

  • A stretch should never be painful. You should only feel a gentle lengthening or release in the stretched tissue.

ExitCare Image STRETCH - Hamstrings/Adductors, V-Sit

  • Sit on the floor with your legs extended in a large "V," keeping your knees straight.

  • With your head and chest upright, bend at your waist reaching for your right foot (Position A) to stretch your left adductors.

  • You should feel a stretch in your left inner thigh. Hold for __________ seconds.

  • Return to the upright position to relax your leg muscles.

  • Continuing to keep your chest upright, bend straight forward at your waist (Position B) to stretch your hamstrings.

  • You should feel a stretch behind both of your thighs and/or knees. Hold for __________ seconds.

  • Return to the upright position to relax your leg muscles.

  • Repeat steps 2 through 4 for Position C for the right leg.

Repeat __________ times. Complete this exercise __________ times per day.

ExitCare Image STRETCHING - Hip Flexors, Lunge

  • Half kneel with your right / left knee on the floor and your opposite knee bent and directly over your ankle.

  • Keep good posture with your head over your shoulders. Tighten your buttocks to point your tailbone downward; this will prevent your back from arching too much.

  • You should feel a gentle stretch in the front of your thigh and/or hip. If you do not feel any resistance, slightly slide your opposite foot forward and then slowly lunge forward so your knee once again lines up over your ankle. Be sure your tailbone remains pointed downward.

  • Hold this stretch for __________ seconds.

Repeat __________ times. Complete this stretch __________ times per day.

ExitCare Image STRETCH - Adductors, Lunge

  • While standing, spread your legs

  • Lean away from your right / left leg by bending your opposite knee. You may rest your hands on your thigh for balance.

  • You should feel a stretch in your right / left inner thigh. Hold for __________ seconds.

Repeat __________ times. Complete this exercise __________ times per day.

ExitCare Image STRETCH - Adductors, Standing

  • Place your right / left foot on a counter or stable table. Turn away from your leg so both hips line up with your right / left leg.

  • Keeping your hips facing forward, slowly bend your opposite leg until you feel a gentle stretch on the inside of your right / left thigh.

  • Hold for __________ seconds.

Repeat __________ times. Complete this exercise __________ times per day.