What is Saphenous Nerve Entrapment

Saphenous nerve entrapment is a condition that results from pressure on a nerve in the leg (saphenous nerve). The saphenous nerve runs down the thigh, along the inner leg, and branches to the ankle and foot. This nerve provides feeling (sensation) to the inner knee and lower leg.

Saphenous nerve entrapment can lead to pain, numbness, and loss of feeling in the knee or leg.

What are the causes?

This condition is caused by pressure being placed on the saphenous nerve in your inner thigh and knee. The pressure is often caused by:

• Scar tissue from repetitive injury or from surgery.
• Trauma to your knee or leg.
• Inflammation where your muscles insert at your inner thigh (pes anserine bursitis).

What increases the risk?

The following factors may make you more likely to develop this condition:

• Participating in:
  • Sports in which you may get hit in the leg, such as football or baseball.
  • Activities that involve repetitive or strenuous use of the thigh muscles, such as running.
• Having had surgery on or near your knee.

What are the signs or symptoms?

Symptoms of this condition include:

• Tingling or numbness on the inner side of your knee or leg. Sometimes, this can occur on the inner side of your foot as well.
• Pain, burning, or tenderness on the inner side of your knee or lower leg.
• A deep ache in your thigh.
• Increased pain when doing activities such as running, jumping, kneeling, stair climbing, or prolonged walking.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history.
• A physical exam. During the exam, your health care provider may:
  • Press on areas around your knee and thigh.
  • Check the motion and strength of your leg.
  • Put your leg in positions that place tension on the nerve to see if that increases your symptoms.
• Tests to rule out other conditions and to confirm the diagnosis. These may include:
  • Ultrasound or MRI to check your muscles, tendons, nerves, and other soft tissues, as well as your bones.
  • Nerve conduction study to see how well the nerve is carrying a signal.

How is this treated?

Treatment for this condition may include:

• Resting your leg and avoiding activities that increase your pain or symptoms.
• Medicines to help reduce pain and inflammation.
• Applying ice to the area to relieve pain.
• Massage to ease discomfort and reduce inflammation near the affected area.
• Injection of an anti-inflammatory medicine into the affected area (cortisone shot).
• Physical therapy exercises to restore strength and flexibility in your knee and leg.
• Surgery to relieve pressure on the nerve. This may be needed if other treatments do not help.

Follow these instructions at home:

Managing pain

• If directed, put ice on the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

Activity

• Avoid activities that cause symptoms.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do exercises as told by your health care provider.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Make sure to use equipment that fits you. Wear padded protective equipment during contact sports.
• Be safe and responsible while being active to avoid falls.

Contact a health care provider if:

• You cannot put weight or pressure on your leg without pain.
• Your pain and symptoms get worse, even with rest and treatment.

Get help right away if:

• You cannot move your knee. This may indicate that other structures are damaged.

Saphenous Nerve Entrapment Rehabilitation

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your thigh. These exercises also help to relieve pain, numbness, and tingling.

Exercise A: Saphenous nerve glide

1. Stand with your left / right knee bent to an “L” shape (90 degrees) and rest the top of your foot on a chair behind you. Hold onto a table or counter for balance.
2. Straighten your left / right arm and put it overhead. Arch your back slightly.
3. Bend both of your knees so your left / right knee drops down near the floor. Let your back bend slightly forward.
4. Hold this position for __________ seconds. Then return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: V-sit (hamstring and adductor stretch)

1. Sit on the floor with your legs extended in a large “V” shape. Keep your knees straight during this exercise.
2. Start with your head and chest upright, then bend at your waist to reach for your left foot (position A). You should feel a stretch in your right inner thigh.
3. Hold the stretch for __________ seconds. Then slowly return to the upright position to relax your leg muscles.
4. Continuing to keep your chest upright, bend at your waist to reach forward (position B) to stretch your hamstrings. You should feel a stretch behind both of your thighs and knees.
5. Hold the stretch for __________ seconds. Then slowly return to the upright position to relax your leg muscles.
6. Bend at your waist to reach for your right foot (position C). You should feel a stretch in your left inner thigh.
7. Hold the stretch for __________ seconds. Then slowly return to the upright position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise C: Lunge (hip flexor stretch)

1. Kneel with your left / right knee on the floor and your other knee bent and directly over your ankle.
2. Keep good posture with your head over your shoulders. Tuck your tailbone underneath you. This will prevent your back from arching too much.
3. You should feel a gentle stretch in the front of your thigh or hip. If you do not feel a stretch, slowly lunge forward with your chest up.
4. Hold this stretch for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.