In this video, I'm going to tell you about inner knee pain from the saphenous nerve,
how to find it and treat it.
When it comes to inner knee pain that healthcare professionals often think that it's coming
from a meniscus tear and osteoarthritis problem, or a ligament injury on the inside of the
knee.
And it is possible to have those conditions at the same time as a saphenous nerve problem.
But there are some distinct differences that are unique to the saphenous nerve.
So let me tell you about the saphenous nerve, the saphenous nerve is one of the longest
nerves in the body, it comes off of your low back at L three, and L for about right in
this area.
And then it runs through your hip into a big nerve called the femoral nerve, right deep
in the front of the thigh, and then that nerve, the femoral nerve innervates, all the quad
muscles of the thigh, but there's one branch that comes off that big femoral nerve, and
runs this way into the inside of the knee, kind of on the back of the knee, and then
it runs down the shin, all the way down into the ankle, and arch of the foot on the inside
of the ankle and the arch of the foot.
That same nerve, the saphenous nerve has little branches that go in different directions.
And specifically, there's one branch that comes over the front of the knee under the
kneecap, right about where the knee joint line is, which is the same location as where
people get arthritis in the knee, and meniscus tears and ligament injuries, that's something
unique to this nerve is it's just a sensation nerve, meaning it does not go into muscles,
it really doesn't innervate any muscles.
So as far as symptoms, you're probably not going to get any muscle cramping, muscle aches,
you're more likely to feel just a deep ache, throbbing and burning sensations.
Some other sensations that I've heard patients report from saphenous nerve problems is a
feeling of water on the knee, I think this is where the water on the knee term comes
from.
It feels like there's like a trickling of fluid or something coming down, usually inside
sometimes the front of the knee right where the nerve passes, it might even be on the
thigh.
And that's from the sensations to the nerve, very much like when you hit your funny bone,
and you get a zing of pain.
And then you have a lingering discomfort that hangs out in this part of your arm, you can
get similar sensations going into your knee.
Now let's talk about how to find a saphenous nerve problem.
Now this is hard to diagnose even for healthcare professionals.
And like I said earlier, it's often happening at the same time as other knee problems.
Now as a result of that there is not a clear cut way to diagnose a saphenous nerve problem.
So I'm going to give you my own experience in diagnosing this problem and give you my
the way that I find it the way that I ask questions to identify if it's more of a saphenous
nerve problem that we need to deal with as a priority versus another issue like a meniscus
ligament, or cartilage or arthritis problem.
One of the biggest telltale signs of a saphenous nerve problem is of course pain on the inside
of the knee.
But there's also some radiation of pain up into the thigh and down into the shin.
So people will often say that they have pain right on the inside of the knee, they'll usually
be able to find a spot in the knee that is particularly tender.
But then they'll also say they have some aching in this area and down on the inside of the
leg.
And that's usually not a big ache up here higher or lower.
The focus of the pain is here.
But people if I ask people will think about and they'll say yeah, you kind of have a little
bit of discomfort down here and up here in the thigh.
And then of course you can poke it and see if you can find any tender spot.
So I just get in there with a few fingers just like this gently, you don't have to push
very hard might be irritated.
And if you dig in the right spot like for me that's where my saphenous nerve is I can
just I know that sensation, I know what it feels like.
It is just a little tender or sore.
And if you have an irritated saphenous nerve, you might be very tender and sore compared
to the muscle.
Right next to it on either side.
If you go this way, there's muscle, there's a nerve and if you go this way, there's your
groin, your inner thigh muscles right here.
And that won't be as tender as where the nerve passes right through here.
And you can also find some tenderness down on the shin.
So if you find your shin bone right in the front, and you just go to the inside of it,
maybe a little higher here on the inside of the shin bone.
If you feel the inner border, the shin bone and try to get as far back as you can before
you kind of lose it in the muscle.
That's about where the saphenous nerve is.
And you can kind of poke in there and if it's real tender, that might be a saphenous nerve
problem, then that's causing your inner knee pain.
And you have to compare this with the other side.
So you'll have to go over and pick the same spot on the other side.
And if it's not as tender, it's going to be tender, by the way because it's a nerve, any
nerve you poke on it.
Even if you're a healthy individual with no nerve problems, it's just going to be a little
tender and sensitive.
But if you have a difference in tenderness on one leg, that's the one that's bothering
you, then that's a sign that that saphenous nerve is irritated right now, that's another
sign to look at is, if you have just a pure saphenous nerve irritation of saphenous nerve
injury, you won't have a loss of motion in the knee joints, you should be able to theoretically,
bend your knee all the way and straighten your knee all the way both sides should move.
Similarly, if you've been to the doctor for this problem, they have probably given you
X rays, maybe even did an MRI.
And they'll tell you that nothing's wrong.
And this is always frustrating for patients, because they're kind of hoping they can see
the problem on the X ray, the MRI, that way we can pinpoint it and nail down what needs
to happen next and move on.
But it's you are kind of left hanging if the X ray comes back, looking completely normal,
and then you get an MRI and the doctor says, There's nothing for me to address here, the
MRI looks great, you don't have any problems that are visible in the MRI, then, you know,
it's kind of good news.
And bad news is good news in that nothing structural is damaged as far as your bones
and your cartilage.
But you're still left with that deep ache, burning throbbing sensation on your inner
knee, possibly your lower leg and thigh.
And then the other telltale signs is the time of day that this problem hurts.
Usually people get worse as the day goes on.
I say usually because this doesn't fit, clear cut.
I think for my experience has been about 80% of people that have saphenous nerve problems.
They report that at the beginning of the day, they feel the best.
And as the day goes on, they just get worse and worse.
And when they're more active during the day.
They're even worse as the evening comes around and into the night.
And often they have trouble falling asleep at night because of that inner knee pain.
And the position doesn't change that much.
You know, get bending your knee more straighten your knee or getting the right pillows.
It doesn't affect it very much.
The only thing that I've heard people saying that positionally might help is if they're
lying on their side trying to fall asleep if they put a pillow between their knees,
because then their knees aren't touching.
Because that pressure of the knees touching can further irritate and already irritated
saphenous nerve that's the only thing I've heard.
But as far as lying with your knees straight line with any bents being on this side or
that side, people don't really report that one is better than the other.
So if you thought about your condition, felt around where your nerve runs, and you think
that you have a saphenous nerve problem that you're going to want to hear this next part.
I'm going to tell you how to treat a saphenous nerve problem if you go visit the doctor for
this and they actually think about the saphenous nerve and investigate it, which rarely happens.
And I can tell you my personal experience, I have never had a patient come in with inter
knee pain, telling me that their doctor found a saphenous nerve problem or any other health
care professional for that matter.
I've never seen anybody else look at the saphenous nerve problem.
Maybe it's just my region, part of the country that I'm in, that's my own sample.
But it's not something at all that's commonly looked at by healthcare professionals.
Now I'm just doing my own research about what can be done for the saphenous nerve problem.
Physicians are apparently finding this in other parts of the world and country here
in the US.
And they're treating it with medications, of course with you know, with pain medications,
nonsteroidal anti-inflammatory medications, which is like your ibuprofen, and then they
do recommend pain creams, your topical analgesic.
So that's like your BEN gay Biofreeze, Icy Hot those kinds of pain creams.
And I think that's actually a good idea, because it's a very superficial nerve in most parts.
Once it comes down to your knee, it kind of hangs out close to the skin.
And so it's easy to be affected by those pain creams.
Now, those are short term solutions, of course, they're just band aiding the problem, they're
not really getting to the root of the problem more on that soon.
But if you're looking to just try to get a good night's rest, that wouldn't be a bad
place to start.
If you're looking for a more extreme treatment, I did see information about getting a saphenous
nerve block, which is where doctors use a medication to numb the nerve.
And this is commonly done with surgical procedures.
Like if you're going to get a knee operation done, you'll get nerve blocks through the
nerves that go down into the knee so that your muscles aren't trying to block with the
knees doing it.
The nerves are essentially numb, they're calm down, so that they don't work for a while.
And then the surgeon can do the procedure.
In the case of the saphenous nerve, it doesn't have any connections to muscles, it's only
a sensation nerve.
So doing the nerve block, theoretically wouldn't impede on your function like your ability
to walk and move and do things.
It would just numb the nerve.
Again, that's a short-term temporary solution.
I did also see that physical therapy is recommended for this which I think is great.
But I would also question Where do you go to physical therapy for this problem, because
every time I've talked to other physical therapists about saphenous, nerve injuries, they scratch
their head and look at me like, I've never seen that.
And I'm always thinking to myself, you just haven't looked, but it's probably been in
your office tons of times, you just missed it.
But more often than not, they'll probably think that you have a meniscus problem, arthritis,
a ligament issue of cartilage issue, one of those things that commonly causes inner knee
pain, and then they'll give you exercises that they think need to be done to help those
problems.
And oftentimes, it'll be strengthening your inner thigh muscles, your quad muscles in
the front of your thigh.
So we're looking at these muscles, those strengthen these muscles, and the ones in the front of
the thigh thinking that that's going to alleviate the pain on the inner knee and take pressure
off the saphenous nerve, when in reality, the nerve is going right through those muscles.
And because those muscles are now contracting, it actually can irritate the nerve further,
sometimes we'll also look at strengthening the hamstring muscles that happens actually,
quite often, and probably the calf muscles, which I would say isn't really the best plan,
what really needs to happen, here's what I do with my patients is we look at the root
problem.
Because if we can fix the root problem, then we can alleviate the saphenous nerve pain.
And not only alleviate it temporarily, but for the long term so that it's not a recurring
problem.
Because we see this recur all the time, people say that the pain comes and goes, it comes
and goes and it gets worse and worse every time it comes.
And then one day, it's full blown and doesn't go anymore.
And that's why they end up coming into my office here.
The root problem of saphenous nerve pain on the inside of the knee that I find here and
I successfully treat is looking at gluteal strength, but muscle strength and foot strength.
And here's why.
If you think of the nerve pathway, it goes from right here to the inner knee, down the
inner part of the lower leg, ankle and arch of the foot.
If that arch of the foot is collapsing downwards, that adds some tension to the knee.
If your glute muscles, your butt muscles out here aren't strong enough, then what ends
up happening to your legs is every time you go to step your knee collapses inwards, doing
squats, same thing, people often don't use your glutes properly.
So when they're going to do a squat type motion like this, their knees collapse inwards like
that.
And that just tensions the nerve on the inside of the knee that that adds more stretch to
it when the more your knees go in, the more your knees go in and the more stretch is added
to that nerve.
So in order to take pressure off the nerve, you've got to get more in this position.
This adds slack to the nerve, which now puts your arches also in an elevated position.
And it forces you to use your butt muscles back here, as well as the arch muscles of
the feet.
treating these problems.
Foot muscle weaknesses and gluteal muscle weaknesses are truly fixing the root of the
problem.
And identifying the weaknesses is not at all challenging, you've got to figure out which
muscles are weak in the areas.
And then strengthening them is really not that big of a deal either, you just have to
make sure that you're affecting the right muscle when you go to strengthen them because
for instance, squats is a great glute exercise, but it rarely ever targets the glutes the
normal way that it's done with the knees kind of inwards or straight, you have to push the
knees out.
And the feedback that you should be getting is that your muscles are getting fatigued,
tired and they're burning.
If you're doing squats to try to fix this problem, and you primarily feel the front
of your thighs working the quadricep muscles, then you're not doing squats correctly to
fix this problem, you're actually going to be feeding into the problem.
Now the one other thing that could be feeding into this nerve problem that may not be directly
addressed by fixing the glute muscles and the foot muscles like I showed you.
It could be a back problem and L three l four spine problem, which you'd have to have looked
at and investigated.
Of course, with an MRI, possibly an x ray as well.
And it often is a combination of the two will see the glute and the foot muscle weaknesses
along with a spine problem.
And the spine problem may not be a permanent, huge deal to deal with.
It could just be a simple joint that stuck or some muscles that are stiff in the area
that need to be freed up and that also takes pressure off the entire nerve pathway.
To calm down that saphenous nerve.
I need to tell you about this program that I've got.
It's called the 28 Day Knee Health And Wellness Boost Program.
This program is designed at targeting gluteal muscle weaknesses as well as foot weaknesses
to fix the root problem that causes so many knee issues including saphenous nerve problems.
I've got more details about this 28 Day knee health and wellness boost program in the description
below.
And I've also got linked below that some playlists for other conditions that could be causing
inner knee pain.
In case you're finding this video for the first time on your search for inner knee pain
help.
Again, it could be a meniscus problem, a cartilage issues a ligament problem, there's so much
and we've also got a playlist of just inner knee pain help that's linked in the description
below so that you can begin to get help for your internet problem.
I wish you the best of luck in fixing it and I'll catch you in the next video friends.
Bye