Nerve Entrapment in the Foot and Ankle of an Athlete

Abstract

Summary: Nerve entrapments in athletes can manifest as pain or dysfunction in the foot and ankle. Any lower extremity nerves—tibial, peroneal (superficial or deep), saphenous, and sural—can be involved. Some syndromes are more common, based on local factors that predispose the nerve to injury. Specific entities include the tarsal tunnel syndrome (with involvement of the tibial nerve at the ankle), jogger's foot (with involvement of the medial plantar nerve), first branch lateral plantar nerve entrapment, medial dorsal cutaneous nerve entrapment, and interdigital neuralgia. Typical symptoms include neuralgia (burning, shooting, lancinating, or radiating pain), tingling, or numbness along the distribution of the nerve's territory. Management includes activity modification, equipment adjustment, transcutaneous electrical nerve stimulation unit, braces, rest, and medications (topical, oral, or via injection). When these are unsuccessful in resolving the symptoms, surgical release of the nerve may be considered. With proper management, return to athletic function is possible.