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Injuries hurt. Right?
Not necessarily, as in the case of legs—or parts of legs—gone awry: falling asleep, tingling, flopping out of control. This perplexing condition affects runners of all abilities, including professionals.
It first struck professional runner Chris Derrick of the Bowerman Track Club about four or five miles into the 2018 Cherry Blossom 10-mile race. He later described it in an Instagram post as the “dead-legged loss of coordination that seems to build throughout hard, continuous efforts.” It got so bad this spring that he stepped off the track halfway into The Ten 10k in February.
“I can feel a certain awareness of my left side being ‘off’ more or less all the time. The most significant element for my running is that my left hip and hamstring feel sluggish, like my leg cannot snap, either off or into the ground. It’s especially aggravated a couple miles into continuous workouts,” Derrick says.
Derrick is used to adversities after years of competing at a high level since high school: He was a 14-time All-American at Stanford and won three USATF cross country championships. “I can get through so much. I can’t get through [this] when 100% of effort is needed,” he says.
He doesn’t have a diagnosis for the phenomenon. It hasn’t been as painful so much as it has confounded him. After nearly three frustrating years of trying what he calls the most obvious solutions—nerve flossing, reactive and strength work, resetting hip alignment—he thinks his new physical therapists, including BTC’s Colleen Little, are onto something by addressing his movement patterns.
The path to resolution, or at least full range of motion, control, and power, seems to be a rocky route for most athletes with legs gone awry.
What are “Wonky Legs”?
When all or parts of a runner’s leg go numb, tingly, and/or noodly, it’s cause for concern. Numbness and tingling in your limbs can be signs of both minor and serious diseases and conditions, including nutrient deficiencies. So, as always, see a medical professional with concerns.
For runners, including Derrick and other pros like Stephanie Twell and Ellie Greenwood, the wonky leg predicament throws a wrench in training, racing, and even staying upright.
For simplicity’s sake, let’s call this nebulous cluster of difficult-to-describe symptoms “wonky leg.” Much like “sciatica” or “shin splints,” we’ll use “wonky legs” to refer to the effects—including total or partial numbness, tingling, and loss of control and power—rather than the cause.
That said, let’s also take a look at the potential causes and solutions.
Finding the cause of a persistent, vague leg issue is not as clear-cut as, say, diagnosing and treating a stress fracture. Symptoms, causes, and potential diagnoses vary day by day and from person to person. So do treatment options as well as health care providers’ understanding of the symptoms, causes, and conditions. (Take, for example, iliac artery endofibrosis, a condition in cyclists and other endurance athletes who lose power and sensation in their legs that’s become more commonly diagnosed.)
“The crucial point is the assessment and evaluation,” says athletic trainer Ross Dexter, at Southern Oregon University. A thorough evaluation should include neuromuscular and functional assessments and ruling out red flags, such as spinal issues and traumatic accidents.
The key to proper assessment? “Find a competent medical pro who understands athletics,” he says. This includes a physical therapist or athletic trainer, who can refer you to a physician or specialist if an underlying condition is suspected at the neurological, physiological or a specific local level, as with exertional compartment syndrome or nerve root entrapment in a disc or vertebrae. Because numbness, tingling, and pins-and-needle-type sensations are common types of nerve pain (a.k.a. neurogenic pain), it’s important that the professional understands how nerves work and how to treat them.
Potential causes of wonky legs can include spine and back issues (think: herniated disc) and nerve injury or impingement. The trick with the latter is finding out where, exactly, the nerve has a problem. If a doctor orders imaging, know that MRIs and high-resolution ultrasounds may help find swelling (known as “edema”) or abnormality, but nerve pain can be referred to another part of the body. In other words, where you feel it might not be the root of your issue.
Nerves can be injured anywhere along their length, but often get compressed or entrapped at the specific locations through which they travel. In the lower limbs, for example, at least five nerves could be entrapped: the peroneal, tibial, rural, femoral, and sciatic. Impingement may occur in the lower leg muscles, back side of the knee, and the hip and glute area.
“Just remember, it is all connected,” says Dexter. “Each of these potential contributing issues are likely connected and may be caused by dysfunction at the core, hips, foot, and/or ankle as compensatory stress patterns arise while your body tries to keep moving you forward through the world.”
Twell, the Scottish marathon record holder and British 10K champ, prides herself as an athlete who’s very kinetically, physiologically aware, yet she found an issue bouncing from her hip to her foot hard to put her finger on. “Neurally, things started to switch off for me into [higher] mileage. I noticed there was a lack of power with the hip drive,” she says. It affected her speed work, too. “I knew the pain was more of a chain reaction because I was strong in certain areas…scores had improved,” she says. “It was very, very hard to find anyone who would acknowledge the pain I was feeling.”
What Should You Do When Experiencing Wonky Legs?
So, should runners with numbness, tingling, or loss of sensation in their legs keep running? Slow down? Stop and rest? Try cross-training? It depends. There is currently no standard protocol that exists, especially because wonky legs symptoms are rarely standard, let alone simple to understand. Healthcare professionals shared a range of takes and say it depends on your unique situation.
1. Listen to Your Body
The first step to answering this question is, like many running ailments, listening to your body. That’s right: actually listen to the signals your body is sending you. That means tuning into sensations, ideally with curiosity and openness.
Take, for example, a numb foot. Notice a pins-and-needles sensation? You might then stop and loosen up your laces or modify your gait. If you choose to ignore them you may risk tripping and/or exacerbating agitated nerves. If your pain doesn’t respond to traditional treatments like rest and ice or is highly variable, that’s another sign it’s nerve-related. If a quick adjustment doesn’t help, and the sensation impedes your progress (whether with pain and/or loss of function) pay attention.
Your brain, spine, and nerves are “the information pathway,” says Dexter. “It’s giving you information…the nervous system is telling you what’s happening…that environment needs to be investigated.”
2. Address It Early On
Doctor of Physical Therapy and long-time runner Lara Johnson, founder of Yellow Brick PT in Boulder, Colorado, has a unique perspective as a runner and clinician. “Coming from someone who loved to push through, the main thing I would say is when we start to notice these subtle problems it’s best to not ignore it. We’d rather address it when it’s subtle than when it gets to be a big problem,” says Johnson. “It’s tricky because we need to read our body.”
If running exacerbates pain, “off” sensations, or loss of function, that is a call to cut back on running and figure it out. Yes, even if you have yet to lose full control or power. If workouts or races cause drop foot, for example, Johnson advises not pushing through. Higher efforts, intensity, and range of motion can exacerbate the movement and postural patterns that cause these issues, she says.
For hard-charging runners, this can be as hard a pill to swallow. When Dani Espino, DPT, was in physical therapy school and training for her first Boston Marathon in 2018, she noticed some isolated lower back pain and did the “typical runner thing, even though I know better. I kept training,” she says. Even after she had shooting pain and tingling sensations from her back to her right toe, and saw a PT who diagnosed her with a herniated disc, she kept training—until she couldn’t. Sharp shooting pain stopped her.
She rested and did strengthening exercises every other day, including glute bridges, bird dog, and prone extensions. Eventually, she ran again. “I made it to the start line and to the finish line,” she says. “Absolutely some injuries require you to take time off, and not just ignore them. Trust the process and be patient with the rehab,” she says. For her, “it was a matter of adjusting the mindset around the goals you have.”
3. Note What Rehab and Treatments Work for Your Body
A host of treatments and modalities could help with symptoms and cause, but what will work for an individual depends on knowing what, exactly, is going on and paying attention to what works for your body. For example, Dexter says, “[Nerve] flossing is a great direction to go, but you have to know which direction to go.” Other treatment options include massage, Rolfing, dry needling, and acupuncture. More invasive techniques include hydrodissection and injections.
Then see, too, potential training factors: mobility, strength, movement control.
4. For Acute Sensations, Ice
For acute cases, Johnson, DPT, recommends calming down nerves with an icing protocol (five minutes on the front and back of the lower spine, at least 15 minutes off, six times a day), gentle elongation stretching, hands-on treatment, and committing to a plan of care—one thing at a time. “Am I wanting to do a bunch of stuff because I think that will help? Or am I sensing into my body? Am I trusting my own knowing and awareness?” Johnson asks.
5. Be Patient
Patience is paying off for Twell. Looking at all the variables, she noticed exacerbation during the UK’s pandemic lockdown, which closed gyms and reduced daily movement. She has experimented with resting, running on inclines, and altering her training, schedule, pre- and post-run routines. Now, training in Houston six months after her flare-up, she has “access to a gym, therapy, shockwave treatment—that really turned a corner for me,” she says.
6. Celebrate Steps of Progress
Derrick is seeing a light at the end of the wonky tunnel, too. He says, “I had a much more positive experience at the Gate River Run 15k. A tough, but essential thing for me has been realizing there will be no quick cure at this point and that I will need to celebrate moments of progress as I diligently stick to my rehab program.”
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