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749 Views 1 Reply Latest reply: Oct 20, 2012 7:53 AM by JamesJohnsonLMT
ngfn183 Rookie 1 posts since
Oct 19, 2012
Currently Being Moderated

Oct 19, 2012 5:50 AM

Pain on Outer/ Side area of quad. Answers?

So I am a well seasoned runner who has been blessed with very few running injuries over the years. Recently over the summer I hurt my IT band and have been rehabbing and strengthening the muscles as well as take some time off. Since then my IT band feels a lot better (knee and hip included) but I have this pain on the outer side of my left quad (couple inches above the knee) that almost feels like a knot or I can at least pin point the place of pain. When I try to run or bike I can feel a tingling-ish feeling but it is nothing painful. I would like to start running again soon so I can start my training for the Boston Marathon. I've read on some threads that using a foam roller can help, but I find it painful and as if the knot feels bigger or at least hurts more after I roll.

 

If anyone knows anything about this or has any suggestions to stretch or strengthen the area please let me know.

 

Thanks!

Matthew              

  • JamesJohnsonLMT Legend 1,167 posts since
    Aug 23, 2009
    Currently Being Moderated
    1. Oct 20, 2012 7:53 AM (in response to ngfn183)
    Pain on Outer/ Side area of quad. Answers?

    Boy I'd hate to start training for Boston with an injury. The ones that accumulate are bad enough. You are probably correct in pinpointing the knot as something at least involved with the problem, but knots, especially ones large enough to be easily found, do not necessarily resolve after just any massage technique.

     

    My take on foam rolling is that it can be helpful for maintenance and minor problems. Major trigger points need more targeted pressure. Rollers tend to spread the pressure out too far and aren't specific enough to the spot that needs attention. A scattershot approach to pressure-based therapies can actually cause trigger points.

     

    We'll assume the knot is in the Vastus Lateralis quad muscle and/or the superficial IT Band, which is capable of some contortion as well. Since you have found it and worked on it, what manual techniques have you used other than the roller? Finding it with your fingers, and pressing hard enough to define it and produce pain, is what we call palpation, an exploratory technique. To isolate the knot and treat it specifically, you want to use an ischemic compression technique.

     

    Every now and then I will see a foam rolling video that shows a pause on the knots that hurt. That's sort of the idea, but it's like trying to open a power gel with baseball gloves on. Find a place where you can sit comfortably with your leg extended, taking care not to contract the quads so they remain soft. Get you thumbs and fingers down there onto that knot, find and focus on the center with slow gradual pressure. Aim for a 7 on the 1-10 pain scale, and hold it for 10 seconds or so. Slowly release to let blood flow back in to the area, and repeat a few times. Perform this technique a few times a day, and expect the re-learning process to take weeks, especially if you are continuing to train.

     

    Sometimes, I have found it more effective to bend the knee and curl my fingers under the muscle to reach it from the other side. Grab a hunk of that quad and squeeze it while pulling it away from the bone. You can easily feel the groove between the quad and the hamstring tendon underneath. This has been a very productive strategy for me when I've had flare-ups in the same area. You can even do this in your car at stop lights. A few hits of several seconds each per treatment is all it takes. I consider this to be maintenance too, but obviously, you can't do this with a roller.

     

    Good luck with your training. Your mileage is probably low enough at this point to resolve the injury before continued training makes that a very difficult task, but many athletes do their speed and hill work at this time. I'd back off on any hard training until you can gauge some progress in this injury.

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