 Poster: A snowHead
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Greetings again, good SHds.
Anyone ever suffered from pain at or soft tissue or nerve (Peroneal) issues associated with the lateral Fibular Head (the bump just below the outside knee) - or TibioFibular joint as it's also called? Anyone heard of this and have any advice or input?
I have recently been told (by an apparently quite well qualified and experienced sports therapist, with symptoms and some strapping relief to match) that my residual, but seemingly now chronic (annoying but fluctuating) outer knee & leg pain is not, as the NHS physio said, "wear and tear" (which might be good news, then) but a lack of normal movement (adhesions or whatever) of the Fibular Head against the Tibia.
Treatment seems to be heat and manipulation and maybe stretches.
Never heard of this before, though Googling and YouTube does support what I am feeling and being told. Never told about it or had it picked up by any treating physios or other therapists during knee trauma & ligament rehab, though it's been there in some form or other ever since.
Cheers, all.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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IT band referred pain. Look upstream, massage of quad and into hip flexors as a start. Lots of exercise for IT band stabilisation. It band bursis gets inflamed on boney knob.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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@orange, From some basic research, it seems that there seems to be a lot of debate as to whether there is ITB involvement in the symptoms which present. Certainly lots of close attachments.
I initially thought that it was indeed ITB (hadn't thought of a bursitis), but the therapist says no, and the physical manipulation of the Fib Head also seems to suggest otherwise. There's a fair bit of lateral lower leg irritation too, not upper.
The Lateral Vastus(?) Quad muscle is also, apparently, not firing well (VMOs are OK) - but otherwise can't as yet find or stretch anything "upstream".
But I'm prepared to be proved wrong...
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You need to Login to know who's really who.
You need to Login to know who's really who.
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@Grizzler, it,s not a weight bearing joint so unless there was trauma or infection involved I don't see how there would be osteo arthritis involvement.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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You'll need to Register first of course.
You'll need to Register first of course.
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| Grizzler wrote: |
Greetings again, good SHds.
Anyone ever suffered from pain at or soft tissue or nerve (Peroneal) issues associated with the lateral Fibular Head (the bump just below the outside knee) - or TibioFibular joint as it's also called? Anyone heard of this and have any advice or input?
I have recently been told (by an apparently quite well qualified and experienced sports therapist, with symptoms and some strapping relief to match) that my residual, but seemingly now chronic (annoying but fluctuating) outer knee & leg pain is not, as the NHS physio said, "wear and tear" (which might be good news, then) but a lack of normal movement (adhesions or whatever) of the Fibular Head against the Tibia.
Treatment seems to be heat and manipulation and maybe stretches.
Never heard of this before, though Googling and YouTube does support what I am feeling and being told. Never told about it or had it picked up by any treating physios or other therapists during knee trauma & ligament rehab, though it's been there in some form or other ever since.
Cheers, all. |
Proximal Tib-Fib joint problems do exist - but there are a lot of much more common problems that cause pain in that region.
Nerve involvement usually spreads down the leg.
The joint can get stiff . If it does i always assess whether there has been an injury to the very complex arrangements of ligaments in that part pf the knee. It can become stiff with ankle problems( fracture, ligament injury, poor rear foot alignment). It also becomes stiff in association with ITB tightness. Just how stiff the joint is varies quite a lot between individuals so you really need to compare the two sides.
It may be worth noting , that in my experience, the posterolateral part of the knee is the most difficult to nail a clear diagnosis because so many things can cause it to be uncomfortable and tender.
Jonathan Bell
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Thank you, Dr JB.
I'm certainly finding it remarkably difficult to get any therapist or physio to make any form of clear 'diagnosis' - a lot of observations about what is stiff, sore, tight, tender, not moving properly, etc, etc, etc (to which read all and everything, especially laterally, though anterior to medial rather than posterior, really) - but nothing firmly causal is detectable, apparently. (Can happen bilaterally with me, BTW: generally traumatised both knees - but nothing laterally, so I was told, ACLs and MCLs only.)
I may end up paying privately for new MRI or ultrasound scans just to see if anything can be found which might explain things.
At the time of the original damage I was told no meniscal or cartilage damage; some therapists have now suggested accelerated 'ageing' now due to inflammatory damage as a result of the original injuries and subsequent changes in knee function sans ACLs. This site and type and pattern of onset of pain and 'irritation' has, however, been present ever since I could undertake any activity post rehab, though it does come and go.
Re possible nerve irritation, the symptoms do certainly spread down the leg as well as sometimes up, although no classic neurological signs have been noticed. I was told that this can be entrapment around the fib head.
No known associated ankle injuries. I have asked a foot biomechanics person, but again nothing specific has been noted or proposed here.
I thought ITB initially, but that's the one thing which everyone's dismissing, oddly. Does perhaps seem a little low for that, too.
Oh well, back to the hot wheat bags, vigorous grabbing and massaging and outer lower leg stretches (all of which help) and a sideways patellar tendon strap support.
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@Grizzler,
Clarity on diagnosis required methinks.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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| Jonathan Bell wrote: |
| Clarity on diagnosis required methinks. |
It would indeed be nice; and not for want of asking, searching, trying and paying, believe me... Apparently, not a chance of NHS actually scanning it, and I presume without that no-one will be definitively the wiser, bar "well, of course, as we all age..." and "doubtless the original trauma and inflammation will have caused [x]".
As mentioned, I might be able to get private scanning, but I have to decide what I need. Would you say that MRI or ultrasound is better? (One therapist suggested the latter as it could check what's happening whilst and before/after the knee is being moved or is bent vs straight - in case there was some meniscal catching or something?) How far up/down the leg should be investigated, or would it be pure knee to fib head?
Thanks.
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@Grizzler,
I think a clear diagnosis always starts with a thorough clinical assessment.
The question that arise from that are then dealt with by “interrogating the scan”.
Part of the problem with lateral/ posterolateral knee pain is that the source of the pain can be remote from the site where you feel it.
Eg if the pain is in fact coming from your back you need a back scan not a knee scan.
Just going on a “fishing expedition” with a knee scan will frequently flag up pathology on the scan, which if not relevant can result in over treatment or unnecessary treatments .
A knee scan should always include the tub- fib joint.
Jonathan Bell
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