I find it interesting to note that I have treated an athlete/pat with VERY similar symtoms as the pat you describe, who was evaluated by orthopaedic surgeon and recommended for surgery, but who recovered almost completely with the below therapy.
Maybe this can be of some help?
Meralgia paresthetica (impingement of n. cutaneus lat femoris) due to cycling activities has increased muscular development/tone of muscles (deep hip flexors) passing under the inguinal ligament? If so, pat should be sensitive to provocative palpation around ligamentum inguinale and/or deep but gentle palpation of muscles.
PT-Rx: Aggressive stretching protocol (of hip muscles as found by test/palp) to do every day (or at least 5 d/wk) plus strech before and after cycling for a few weeks should make a difference. Could also be combined with mobs/manips/exercises to back if suspection of lumbar spine involvement. If not successful continue streching but exclude cycling and see if it differs... last resort might be surgery to release the nerve... Please note, to get the best results it might be of importance to do the first therapy sessions of streching manually; pats often have very poor "mind/muscle control" which might prevent maximal results from stretching on their own... can be specially true if pat is 39 and has just taken up sports! (Not to be generalized though, athletes like bodybuilders/dancers/gymnasts etc often have very good mind/body control and excellent abilities to adapt to new specific stretching/training techniques.)
Just my 2 cents...
Best of health and good luck with Rx!
Tobias
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Tobias Sundberg, PT
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-----Original Message-----
From: Paul Sumner <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Friday, October 08, 1999 6:58 PM
Subject: I need some help.
>I need some help.
>I am treating a 39 yo male who since starting cycling 8 months ago has begun to c/o antero lateral thigh numb/tingling sensation on the left side. After cycling his thigh is more sensitive compared to the Right. Other than that he says that standing/ lying with the leg straight brings the symptoms on.
>Objectively I was not able to alter the symptoms by using McKenzie repeated movements or manipulative positioning. Palpation of the L/sp was normal and he has full L/sp movements, hip movement and knee. All lower limb muscles were normal when stretched and resisted. ITB was not tender. His SLR/slump was normal and not provocative.
>I think he has a Hyperalgesia of the nerve and have sent him away to 1. cycle within symptom free time.
>2. regular spinal movements
>Anything i've missed?
>PAUL SUMNER: [log in to unmask]
>
>
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