Anatomy TUESDAY – The Saphenous Nerve

I’ve been thinking a lot lately about the saphenous nerve, the longest sensory nerve in the body that is sometimes damaged with knee surgery. I currently have two patients who have had robotic assisted total knee arthroplasty with complaints of severe medial knee pain that appear to be due to saphenous nerve irritation or impingement.

As with all nerves, the saphenous nerve runs a course with potential impingement sites:

Between L2-3 and L3-4
Saphenous hiatus just inferior lateral to the pubic tubercle
Adductor canal in the thigh (bordered by the sartorius, adductor longus, adductor magnus and vastus medialis)
Medial knee underneath sartorius (infrapatellar branch)
Plantar fascia

Palpating for trigger points in the muscles along the saphenous nerve path may reveal areas of impingement. Releasing fascia and trigger points in the adductor and sartorius muscle groups may alleviate pain.

Flossing of the saphenous nerve is an excellent way to restore nerve gliding. Check out this video.

Why does this matter?

Medial knee pain after surgery is common and may involve saphenous nerve impingement or irritation. Nerve impingement may mimic muscular pain as it worsens with activity and is tender to palpation. If your patient’s medial knee pain does not seem to be resolving, try releasing trigger points along the nerve path (adductor, vastus medialis, sartorius) and restore nerve mobility with the flossing technique.

Because nobody has time to be in pain.

Until next time…