Off Topic, but still medically/physio related

[DancerFutureDPT]

Does anyone know the physiological explanation for getting menstrual cramps in your thighs? (haha this isn't something I wanted to ask on Twitter or Facebook). I tried googling it and all I could come up with is it's a common symptom, but no explanation.

I can understand getting cramps in your low back, but I don't understand the leg thing...especially when my knees hurt.

If anyone knows anything or has any information, that'd be great

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[jbizzle]

 

[Daystar]

Does anyone know the physiological explanation for getting menstrual cramps in your thighs? (haha this isn't something I wanted to ask on Twitter or Facebook). I tried googling it and all I could come up with is it's a common symptom, but no explanation.

I can understand getting cramps in your low back, but I don't understand the leg thing...especially when my knees hurt.

If anyone knows anything or has any information, that'd be great

Where in your thighs do you feel the cramps? Is it more in the inside area or outside? And is it on both thighs? If so, do you have bowel and bladder issues (don't have to really respond to this question here if you are not comfortable disclosing it), however if it is a yes, then it may be a sign for a cauda equina syndrome. You can search more about it, but from what I have learned in PT school, this is a serious medical emergency. But feel free to look into and ask your physician about it.

 

[DancerFutureDPT]

haha no issues. It's bilateral, and it's just like a tightness/cramp in the front of my thighs (if you want exact specification, location wise, it'd only be like the rectus femoris, not the rest of the quads). A few of my friends have the same issue too. It almost feels like foam rolling would help, except it doesn't. lol. And it only happens like 2 days per month My lumbar plexis is totally fine though (knock on wood).

I know most girls get LBP, which has never been an issue for me, and that physiologically makes more sense to me. I was just curious about the physiological connection of the thighs to the ovaries. lol.

 

[Daystar]

haha no issues. It's bilateral, and it's just like a tightness/cramp in the front of my thighs (if you want exact specification, location wise, it'd only be like the rectus femoris, not the rest of the quads). A few of my friends have the same issue too. It almost feels like foam rolling would help, except it doesn't. lol. And it only happens like 2 days per month My lumbar plexis is totally fine though (knock on wood).

I know most girls get LBP, which has never been an issue for me, and that physiologically makes more sense to me. I was just curious about the physiological connection of the thighs to the ovaries. lol.

Good to know cauda equina is not an issue. Well, it is hard to say what is wrong without doing a proper evaluation. A lot more information would be needed to find out what is wrong like what causes the pain and what makes it feel better. Also, your posture should be assessed to determine what is the resting position of your pelvis (anterior, neutral or posterior tilt) and how that that affects the lumbar spine. Also, because rectus has an attachment at the pelvis and at the knee, those joints also need to be considered. A Thomas test can be done to determine if you have tight rectus or if it is iliopsoas. If there is tenderness to palpation of the rectus femoris, then this could be due to overuse, posture, or abnormal joint mechanics. A neural component of the femoral artery would also have to be considered since the artery runs anterior to the thigh; this can be done with the prone knee bend test. The rectus has an attachment at the pelvis, iliopsoas also has an attachment at the pelvis and the lumbar spine, and there are many things that go passes through there. So, the ovaries might not have a direct relationship with rectus (at least not that I can think of).

Sorry, if this post is hard to understand, but there are a number of things that should be considered before knowing what's causing your cramps. It could just be how your body reacts. If you are concerned, you should have a healthcare professional take a look at it.

 

[DancerFutureDPT]

I'm well aware of everything you just said, but thanks for the response And it's not muscle tightness or mis-alignment...dancing for 20 years has made me super flexible, but strong, and all my muscles are crazy stretchy. I can put my leg behind my head (no piriformis tightness there haha) and touch my nose to my knees without even trying (I'm partially convinced I don't have hamstrings). lol.

All the women in my family and most of my friends get similar cramps in their knees/thighs during menstruation. I was just curious if anyone knew a physiological reasoning behind it, because even my MD couldn't give an exact answer (he said he thinks it has "something to do with the femoral artery getting compressed during the course of the monthly changes"....yeah thanks haha).

 

[jles]

based on what you have said I wonder if it could just be a referred pain? basically in your situation the sensory information from the uterus during menstruation is entering the spinal cord about the same spinal segments which receive sensation from the crampy/painful area you described in your anterior thighs (about L2-3). The extra afferent information is being perceived by the brain as coming from the thighs when in reality it is from the uterus. There are several theories as to why referred pain occurs...Just a quick suggestion.

I'm well aware of everything you just said, but thanks for the response And it's not muscle tightness or mis-alignment...dancing for 20 years has made me super flexible, but strong, and all my muscles are crazy stretchy. I can put my leg behind my head (no piriformis tightness there haha) and touch my nose to my knees without even trying (I'm partially convinced I don't have hamstrings). lol.

All the women in my family and most of my friends get similar cramps in their knees/thighs during menstruation. I was just curious if anyone knew a physiological reasoning behind it, because even my MD couldn't give an exact answer (he said he thinks it has "something to do with the femoral artery getting compressed during the course of the monthly changes"....yeah thanks haha).

 

[TGDM]

Nobody really knows...



In fact, it is not really known for sure what the cause of cramps actually is...let alone leg cramps caused by menstruation.


Is it a problem with dehydration? Altered electrolyte levels?* Damaged Sarcoplasmic reticulum releasing Ca++? Decreased iron levels?* Environmental impacts?


In short, my guess is as good as yours.



jles, I haven't read anything that indicates an embryological or developmental relationship between the uterus and Rectus Femoris, nor do I remember any obvious similar associations in the cortex...not that neuro is anything I would consider a strength. Please fill me in.


Daystar, where on earth do you go to school?

 

[jles]

so here's my rationale:

Out of the three primary mechanisms of referred pain (embryologic development, and direct pressure/shared pathways being the other two), I am talking about her sx being caused by (taken from my DDx notes and Goodman text) "multisegmental innervation – The autonomic nervous system (ANS) is part of the peripheral nervous system (PNS). The viscera have multisegmental innervations and pain of a visceral origin can be referred to the corresponding somatic areas. E.g. cardiac pain can occur in any structure innervated by C3 to T4 such as jaw, neck, upper trap, shoulder, and arm."

Referring back to my Thieme Atlas, it would work like this: Uterus spasm and pain -> Inferior hypogastric plexus -> Sympathetic Chain Ganglia -> SC segments L1-L4 --> Rectus Femoris nerve roots L2-4 --> Brain -> Rectus Fem.

That it appears to be isolated to that muscle along with the cyclical nature of the sx associated with her period makes me think maybe not dehydration (why not spasm anywhere else?) and not muscle damage nor iron (because why just rectus having spasm?)...Of course who knows, but it's interesting to think about!

John

Nobody really knows...

jles, I haven't read anything that indicates an embryological or developmental relationship between the uterus and Rectus Femoris, nor do I remember any obvious similar associations in the cortex...not that neuro is anything I would consider a strength. Please fill me in.


Daystar, where on earth do you go to school?

 

[DancerFutureDPT]

Daystar, where on earth do you go to school?

LOL. I kinda thought that too...talk about hearing footsteps and thinking zebras

Thanks TGDM and Jles...I kinda figured there's no way to know for sure, but both of your explanations seem plausible. I have read about electrolyte/iron deficiency etc., but kinda as Jles said, why only cramp in my thighs instead of my arm or calf or whatever. It is probably a combo platter of things. But I'm sure lots of women will love the GYN who discovers the actual cause and a cure lol.

Thanks guys

 

[MotionDoc]

so here's my rationale:

Out of the three primary mechanisms of referred pain (embryologic development, and direct pressure/shared pathways being the other two), I am talking about her sx being caused by (taken from my DDx notes and Goodman text) "multisegmental innervation – The autonomic nervous system (ANS) is part of the peripheral nervous system (PNS). The viscera have multisegmental innervations and pain of a visceral origin can be referred to the corresponding somatic areas. E.g. cardiac pain can occur in any structure innervated by C3 to T4 such as jaw, neck, upper trap, shoulder, and arm."

Referring back to my Thieme Atlas, it would work like this: Uterus spasm and pain -> Inferior hypogastric plexus -> Sympathetic Chain Ganglia -> SC segments L1-L4 --> Rectus Femoris nerve roots L2-4 --> Brain -> Rectus Fem.

That it appears to be isolated to that muscle along with the cyclical nature of the sx associated with her period makes me think maybe not dehydration (why not spasm anywhere else?) and not muscle damage nor iron (because why just rectus having spasm?)...Of course who knows, but it's interesting to think about!

John

for jles

this was also my first thought. Was about to post a similar rationale but then decided to read all the responses first .