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Sports Medicine

Pain in right knee and tightness in groin

01/02/2008

Question:

Approximately 2 months ago I stepped up my normal exercise routine from slow walks a few times a week to fast walks and runs for 30+ minutes a day, 5 or 6 days per week. After about one week with this increased exercise program, I noticed that the tendon on the inside of my left leg was constantly tight. Also, when I bend my leg at the knee to 90 degrees and attempt to rotate my knee (like I am going to sit indian style, or cross my left leg over my right when sitting), I have a sharp pain running from the inside of my left leg (in the groin area) down to the outside of my knee to just below the kneecap. It almsot feels like a piched nerve.

I have tried stretching many times, but it does not help and simply leaves me with the same sharp pain, only for a few minutes after the stretch. It appears to be worst when I bend and rotate at the same time. When my leg is straight I can rotate the knee and it does not bother me. I have also noticed that when my knee is bent for more than 10 minutes, I begin to feel a dull pain in my knee. Also, if I am sitting with my knee bent, and I place any pressure on the top of my leg, I also notice the pain increase in my knee.

Any insight would be greatly appreciated.

Answer:

Symptoms of sufficient severity to interfere with activities and which have not improved after two months should be evaluated by a physician, to provide you with an accurate diagnosis based on physical exam as well as, possibly, imaging studies such as X-rays or an MRI scan.

Although a diagnosis cannot be made over the Internet, a "pinched nerve" would not typically cause pain in the distribution you described. A "pulled muscle" (muscle strain) would typically improve with time, and would usually benefit from (appropriate and properly performed) stretching exercises. The pain in your groin and knee may be "referred pain" - for example, from your hip, or alternatively, from the joint in the middle of the front of the pelvis called the pubic symphysis. Given the onset of your symptoms coincided with an increase in your exercise activities, a stress fracture of your femoral neck (at the hip) is certainly a concern and, if present, is potentially serious. Again, you are strongly advised to be evaluated by a physician ASAP so appropriate treatment can be instituted based on the cause for your symptoms.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University