A common complaint among runners, athletes, and humans in general is back of the thigh and calf pain and tightness that does not resolve with rest and stretching. Deep tissue massage to the areas, specific strength training, ice, and anti inflammatory medication may help but the issues do not fully resolve. The symptoms may or may not include paresthesia (numbness, tingling, or coldness in the thigh, lower leg, ankle, foot or toes). Usually the patient has a history of onset of pain from an injury or just a gradual onset with no known cause. In our clinic we have had many individuals that have seen multiple other providers including doctors, chiropractors, and sometimes other PT’s. If treating the location of the pain has not resolved in 6 weeks or less the problem could be related to nerve tension.
The sciatic nerve goes down the back of the thigh before splitting into two parts above the knee with one branch supplying the outside of the lower leg and foot and the other branch the calf and bottom of the foot. It originates from roots of the spinal cord in the lower lumbar spine. Commonly lumbar discs can bulge and rub on or tether these nerve roots as they exit the spinal canal. This can be happening with no back pain at all, only the leg symptoms described above. If this is the source of nerve tension your lumbar spine joints and surrounding fascia need to be specifically mobilized and decompressed.
Another major location of nerve tension is the tailbone (coccyx). The tailbone is the bottom attachment of the spinal cord or what is left of it after all the spinal nerves have branched out to the body. At the tailbone the spinal cord is just a thin but tough band or filament. The coccyx is easily injured and becomes stiff. Unless an injury is recent coccygeal stiffness is not noticed by the patient. The only presenting symptoms is nerve tension that can cause leg symptoms, or even headaches. The coccyx can be effectively mobilized by a trained manual therapist within a few sessions.
As manual physical therapists we can use our hands to feel mobility, our eyes to observe movement, and ask the right questions to identify this problem and treat it effectively with mobilization techniques to the involved area. Once we locate the area(s) where nerves are adhered we can painlessly and effectively mobilize the involved areas and give you exercises to help heal and prevent recurrence.
A special test we perform is the “Sit/Slump Test”. The image to the left is described as a corrective exercise here at this link: Slump Stretch
You should not do this stretch for self treatment unless instructed by our physical therapists to do so. You can, however, do it gently once to see what it does to your symptoms. You will not likely be successful treating this on your own. Once corrected you should be able to maintain and keep the issue resolved. Come see one of our experienced orthopedic physical therapists or contact us to try and find a qualified practitioner in your area.