Prolonged Squatting Research Articles

Deep peroneal neuropathy induced by prolonged squatting: a case report.

Prolonged squatting is a well-documented cause of common peroneal neuropathy, wherein the common peroneal nerve is thought to be compressed between the biceps femoris tendon and the lateral head of the gastrocnemius muscle or the fibular head. However, deep peroneal neuropathy resulting from prolonged squatting has not been previously reported. We present the case of a tile installer who developed unilateral deep peroneal neuropathy following extended squatting, diagnosed through ultrasonography, which identified the bilateral division of the common peroneal nerves between the knee joint and the fibular head. This case underscores the value of ultrasonography, particularly when electrodiagnostic results are inconsistent with clinical expectations.

Hierarchical clustering analysis of musculoskeletal stress factors and their risk level in cardboard manufacturing: research from PLIBEL.

A hierarchical cluster analysis for the cardboard manufacturing industry was developed with the aim of identifying similarities between workstations in terms of musculoskeletal stress factors (MSFs) and their impact on workers' bodies. The hierarchical clustering analysis was conducted using data from 44 workstations, which included 6 body part divisions and 51 stress factors as variables with 36 answer options. Firstly, the content of the dataset was defined. Secondly, the data were agglomerated and classified into 3 clusters using Ward's method based on the presence or absence of stress factors. Finally, the multivariable matrix was reduced to 2 factors: the x-axis representing the risk level of the workstation, and the y-axis representing the impact on the workers' health. The study found that workers' knees were the most affected body parts, with 47 cases. The resulting work-related musculoskeletal disorders included tendinitis, arthralgia, chondromalacia, and gonarthrosis. The MSF with the most significant impact on the body's health was fatiguing work that involves repeated jumps, prolonged squatting, or kneeling, present in cluster 1 and cluster 3. Moreover, two of the most common MSFs associated with repeated work positions were identified: a mild forward flexion of the back (63 cases) in combination with one leg being used more often to support the body (56 cases). It was possible to identify the main work-related musculoskeletal disorders and the associated stress factors for the cardboard manufacturing industry by using hierarchical cluster classification and analysis, enabling the classification of risk levels and the impact on body health for each workstation.

Work-related musculoskeletal disorders among traditional pottery makers at selected places in Bengaluru – A cross-sectional study

Abstract: CONTEXT: Pottery is defined as clay that has been fashioned into the desired shape and then dried to reduce its water content before being fried or baked to fix its form. The artisans living in traditional societies are normally influenced by their environment as well as by their myths, legends, rituals, ceremonies, festivals, social organization, and cultural norms which are reflected in their creations. The poor environmental conditions and the lack of protective equipment in these pottery workshops are key contributing factors to the development of these occupational diseases. Most pottery industries are small- to medium-scale industries and have longer and irregular working hours, a higher percentage of elderly employees, limited opportunities for health education or health inspection, and insufficient health promotion facilities compared with large companies. These factors are considered to play an important part in the development of occupational diseases and some nonspecific diseases such as psychosomatic, cardiovascular, and locomotor diseases among pottery workers. Traditional pottery making has its unique method of potter-work where it demands prolonged squatting without back support for hours which can develop musculoskeletal disorders (MSDs). AIMS: The study aimed to estimate the prevalence of work-related musculoskeletal disorders (WRMD) among traditional pottery makers at selected places in Bengaluru. SETTINGS AND DESIGN: A cross-sectional study was conducted in two rural communities of Bengaluru. One hundred and ten traditional pottery makers were randomly selected. MATERIALS AND METHODS: Subjects were screened for work-related musculoskeletal disorders (WRMD) using the Nordic Musculoskeletal Questionnaire, following which the pottery makers who reported low back pain (LBP) were screened for the severity of disability using the Modified Oswestry LBP Disability Questionnaire (M-OSW). The results obtained were statistically analyzed using SPSS 25.0. RESULTS: The result showed the highest prevalence of MSDs in the lower back, the findings of this study confirmed the work-related stress on traditional pottery makers. In the present study, the highest prevalence of musculoskeletal disorder was found in the lower back, of which had trouble in the last 12 months, 56.36% were having trouble during the last 7 days, and 19.09% were prevented from doing normal activities during the last 12 months. The prevalence of MSDs during the last 12 months revealed that the maximum of them, i.e., 24.54%, were having pain in the lower back. The present study also found MSDs prevalent in the hip joint and knee joint due to the occupational need to complete the work on prolonged squatting. CONCLUSIONS: This study concluded that prolonged work exposure and awkward work postural demand increase the incidence of MSD among traditional pottery makers in Bengaluru.

Squatting Facets and Trochlear Extensions of Talus Bone in Indian Population

Introduction: The talus is a tarsal bone articulated with the tibia, fibula, navicular, and calcaneus bones to form supratalar, pretalar, and subtalar joints, respectively. A squatting facet is a kind of anomaly that forms on the surfaces where the tibia and talus articulate. The squatting facet states the daily activities and living style of society. Squatting is described as the hyperflexion of the hip and the knee and the movement of hyperdorsiflexion between the leg and the ankle. Materials and Methods: In the present cross-sectional study, 600 dry adult human tali were taken from the osteology laboratory in the Department of Anatomy, King George's Medical University, UP, Lucknow. Each talus was examined for the presence of various patterns of articular facets on the neck of the talus and extensions of its trochlear surface. Ethical clearance was obtained from the Institutional Ethics Committee, King George's Medical University, Lucknow, as reference code: 121 ECMIIA/P3. Results: In our study, we observed that the lateral, medial, and combined squatting faces are 282 (47.64%), 49 (8.28%), and 22 (3.72%), respectively. Lateral, medial, and continuous trochlear extensions are 126 (21.12%), 120 (20.58%), and 31 (5.36%), respectively, in the Indian population. Conclusion: Modifications of the neck of the talus (squatting facets and trochlear extensions) are the result of prolonged squatting positions, which is a common habit of the Indian population, and incidences of these variations can be used as an anthropological marker for racial and regional differentiation of unidentified bones.

Bilateral peroneal nerve palsy due to prolonged squatting in farmers: clinical and electrophysiological outcome

ABSTRACT Introduction Peroneal neuropathy is the most common mononeuropathy of the lower extremities. However, bilateral peroneal nerve palsy (BPNP) is extremely rare due to prolonged squatting. We aimed to evaluate the clinical-electrophysiological findings in patients with BPNP caused by long-term squatting for cotton harvesting in our region. Methods Eight patients (16 limbs), admitted to our center between February 2018 and March 2021 with bilateral foot drop after prolonged squatting, were included in our study. The clinical and electrophysiological findings were re-evaluated six months later. Results We observed that 18.75% of the limbs had pure conduction block, 31.25% had mixed involvement, and half had predominantly axonal damage. Good recovery was observed in ankle dorsiflexion in seven patients during follow-ups. None of the patients were referred for surgery. Electrophysiological examinations showed that the conduction block was resolved, and reinnervation was observed in all patients with axonal degeneration. Conclusion Since the etiology is nontraumatic compression, good recovery can be seen with conservative treatment in BPNP. Electrophysiological studies may determine reinnervation along with clinical examination. The patient should be followed-up for six months with conservative treatment before surgical intervention.

Common Peroneal Injury mistaken as Neuraxial Analgesia Complication after Normal Vaginal Delivery

In obstetrics, commonly involved lower limbs neuropathies are peroneal, sciatic and femoral nerves but peroneal nerve palsy is the most common. Causes of peroneal nerve injury during childbirth include, but not limited to, instrument-assisted delivery, prolonged external knee compression from stirrups or hand positioning, knee hyperflexion, prolonged squatting and sometimes neuraxial anaesthetic technique. We present a case of unilateral common peroneal neuropathy in a vaginal delivery patient under epidural technique.

Plication: an innovative method of treating piles

Background: The cause of haemorrhoids remains unknown. Factors contributing to haemorrhoids are constipation, prolonged squatting, pregnancy, aging, heredity, portal hypertension, abdominal tumour etc.Methods: This prospective study was carried out in department of surgery, M.K.C.G MCH, Berhampur, Odisha, India from 01st August 1995 to 31st July 2017. Patients from both sex and different age groups having haemorrhoids were included. Patients with piles secondary to anorectal tumours, prolapsed and thrombosed piles, anorectal pathology like fissure were excluded from study. Preoperative, intraoperative interventions and postoperative care were carried out according to laid procedure described below.Results: Total 1014 patients of piles were selected for plication and conventional haemorrhoidectomy and most of them were between 31-50 years of age while 362 cases underwent plication, rest 346 cases were treated with haemorrhoidectomy. All patients in this study had bleeding per rectum as the main symptom. Out of 507 patients which has been examined for plication, 272 (53.65%) had 2nd degree, 235 (46.35%) had 3rd degree piles. Results of plication of piles are satisfactory and only 4% patients had pain for which long term analgesics were given.Conclusions: Treatment of haemorrhoids is well debated topic and various methods are being used by surgeons all over world. Plication of piles appears to have significant advantages over conventional methods in terms of patient comfort, duration of stay in hospital and incidence of complications. Literature on this subject is briefly reviewed.

Changes in Lumbopelvic Movement and Muscle Recruitment Associated with Prolonged Deep Squatting: A Pilot Study.

This study examined the changes in spinal kinematics and muscle recruitment of the lumbopelvic region associated with prolonged squatting. Eight subjects with chronic nonspecific low back pain (LBP) and eight asymptomatic subjects (AS) performed squat-to-stand and reverse movements, before and immediately after 15 min deep-squatting. Within-group and between-group differences in lumbopelvic kinematics and electromyographic activity acquired in lumbar erector spinae (ES), gluteus maximus (GM), and vastus lateralis (VL) were analyzed. During squat-to-stand after squatting, the LBP group showed slower then faster lumbar movement in the second and third quartiles, respectively. In the second quartile, the AS group moved with a significantly greater lumbar angle. However, significantly greater bilateral GM activity (+4–4.5%) was found in the LBP group only. A more profound decrease in bilateral ES activity (−10%) was also shown in the LBP group, yet this was nonsignificant compared to the AS group (−4%). In the third quartile, only the LBP group moved with a significantly greater lumbar angle, together with a significant increase in bilateral ES (+6–8%) and GM muscle (+2–3%) activity. The findings of the altered pattern of joint kinematics and recruitment of the key lumbopelvic muscles displayed in the LBP group inform on the possible mechanisms that may contribute to the increased risk of developing lumbar dysfunctions for people who work in prolonged squatting postures.

A study on plication of piles

Background: Haemorrhoids are specialized, highly vascularized ‘cushions’ forming discrete masses of thick sub-mucosa containing blood vessels, smooth muscles and elastic and connective tissues limited to the anal canal and perianal area. The cause of haemorrhoids remains unknown. Numerous factors contribute to haemorrhoidal diseases such as constipation, prolonged squatting, pregnancy, aging, hereditary, portal hypertension, abdominal tumor and defecation habits. Methods: This prospective study was carried out in the department of surgery, GMCH, Udaipur, Rajasthan, India from June 2014 to December 2015 after taking the permission from institutional ethics committee. Patients from both sexes of various age groups having haemorrhoids and associated anorectal pathology such as fissure were included. Patients with prolapsed piles, thrombosed piles and piles secondary to anorectal tumor were excluded from the study. Preoperative Bisacodyl 2 tablets at night before operation and Sodium picosulphate enema was given early morning on the day of surgery to ensure a clear visualization of anal canal. Operative technique: With the patient in lithotomy position after appropriate anesthesia anal stretching was done and thereafter tissue forceps was applied to the skin tags corresponding to the three major piles. A Babcock forceps was then applied to the pile mass above the level of pectinate line. Then the held pile mass was transfixed and ligated with silk 1-0 atraumatic needle suture at the proximal end of the internal haemorrhoids in order to occlude the superior haemorrhoidal vessel as they enter the internal haemorrhoids. If there were any small secondary pile the same procedure would be done. A small piece of gauge soaked with 2% xylocaine jelly would be left in anus as dressing. Results: Total 50 patients of piles were examined and most of the patients were between 31-50 years of age (60%) with males preponderance. All the patients in this study had bleeding per rectum as the main symptom. Among all patients 60% received some form of conservative treatment and partially relieved. Out of 50 patients, 38% had 1st degree piles, 58% had 2nd degree piles and rest had 3 rd degree piles. In this study of plication of piles 94% of cases had no pain, 6% of cases who had pain were also suffering from fissure. The results of plication of piles are satisfactory and only 2% of the patients had pain for which long term analgesics were given. Conclusions: The treatment of haemorrhoids has been widely discussed and various methods are being employed by majority of surgeons throughout the world. In the plication of piles one should appreciate the fulfilment of above mentioned requirements.

Meeting patient expectations and ensuring satisfaction in total knee arthroplasty.

Osteoarthritis (OA) of the hips and knees is estimated to be the fourth leading cause of functional disability globally. OA is strongly associated with ageing and the Asian region is indeed aging rapidly. The morbidity burden of OA in Asia is significantly increasing (1). In Asia, there is a greater demand for a pain-free knee joint of good range of motion due to cultural, religious or simply lifestyle reasons. Asians are more likely to squat and kneel for prolonged periods of time. Prolonged squatting has been suggested to account for a significant variation in prevalence of knee OA between Chinese subjects from Beijing, China and White subjects participating in the Framingham OA study (2). Total knee arthroplasty (TKA) has been thought to be the definitive solution for chronic mechanical knee pain secondary to OA. the definitive solution for chronic mechanical knee pain secondary to OA. The number of TKAs performed has been increasing steadily over the years according to the national registry in Seoul, Korea (3), as with the rest of the Asia-Pacific region. However, patients’ expectations of TKA outcomes seem to differ from the measured outcomes of the surgery (4). Most expected patient-reported outcomes were improvement in pain, restoration of function and resolution of need for assistive devices. There is a significant difference between actual and expected activities after TKA for OA. While TKA relieves pain and restores function beyond doubt, several studies have showed that only 82- 89% of patients expressed satisfaction after their primary total knee replacement (5-12). Patient satisfaction is fast becoming an important tool for assessing outcome of TKA (13). However, patient satisfaction is a complex phenomenon that is affected by many elements that determine health-related quality of life (14). This is influenced by the patient’s cultural, social and psychological make as well. It is well known that many cultural practices in Asia requires the patient to kneel and/or squat and the ability to achieve this post-TKA will undoubtedly have some impact of patient satisfaction scores. Good clinical and functional outcome as determined by clinicians does not always equate to patient satisfaction as the difference between patients’ and clinicians’ perception of good outcomes is well known (15). This has led to the development and validation of patient-reported outcome measures (PROMs) or otherwise known as patient satisfaction scores in orthopaedic surgery. While there are numerous tools to measure patient satisfaction after these procedures, it is the long-term satisfaction that is the most important goal of surgery in patients with OA (11). This editorial will evaluate patient satisfaction following TKA as well as the factors that have a profound influence on satisfaction.

Peroneal nerve palsy secondary to prolonged squatting in seasonal farmworkers

The aim of this study was to evaluate the follow-up and treatment results of peroneal nerve palsy secondary to prolonged squatting for working and to determine an approach for its treatment and prevention. The study retrospectively evaluated 16 patients (7 males, 9 females; mean age: 23.6 years) diagnosed with peroneal nerve palsy due to squatting for work. Clinical and neurological evaluations were performed and weight and height were measured. Lesion site was determined using electrophysiological testing. After diagnosis, medical and orthotic treatment was initiated and rest was advised. Patients were followed until motor symptoms were resolved. Clinical and neurophysiological evaluations were consistent with isolated peroneal nerve palsy. The left side was affected in seven patients, the right side in seven and both sides in two. Average onset of the symptoms was 3.3 (range: 1 to 6) weeks and average daily squatting period was 6.8 (range: 6 to 8) hours. Average healing time was 7.4 (range: 3 to 16) weeks. None of the patients was obese or overweight. All patients healed with conservative treatment and no surgical treatment was necessary. Working conditions and duties should be considered in the evaluation of peroneal nerve palsy. In peroneal nerve palsy secondary to squatting, healing should be expected with conservative treatment, resting and close follow-up.

Modifications on dorsum of neck of talus (Squatting Facets and Trochlear Extensions) in Indians

Objective: Habitual squatting in humans is associated with modifications of ankle especially the neck of the talus (squatting facets) and its trochlear surface (trochlear extensions) that characterize the strong pressure and traction forces on ankle joints in state of hyperdorsiflexion. Present study was done to find out variations and incidences of various types of modifications of neck of talus thoroughly and to determine regional peculiarities of these modifications in Indians. Material and Methods: 300 dry (150 right and 150 left) adult tali were taken for present study. Each talus was examined for the presence of various patterns of articular facets on neck of talus and extensions of its trochlear surface. Statistical analysis of data was performed by using Fisher exact test with 95% confidence limits. Results: Lateral squatting facet was found in 136 tali (45.3%). Incidences of medial, combined & continuous gutter like squatting facets were 7.7%, 3.3% & 4.3% respectively. Lateral and medial extensions of trochlear surface were found in 22.3% and 23.7% respectively. Conclusions: Modifications of the neck of talus (squatting facets and trochlear extensions) are result of prolonged squatting positions which is common habit of Indian population and incidences of these variations can be used as an anthropological marker for racial and regional diff erentiation of unidentified bones.

Squatting, sitting on the floor, or cycling: Are life‐long daily activities risk factors for clinical knee osteoarthritis? Stage III results of a community‐based study

To evaluate the association between occupations, sports, life-long daily activities, and knee osteoarthritis. In this case-control study, we randomly recruited 480 subjects with knee osteoarthritis, who had participated in the first stage of a community-based study in Tehran, and compared them with 490 controls. A questionnaire was used to record all occupations, sports, and the details of 10 daily activities. The mean +/- SD hours/day spent on these activities were calculated and compared using the lightest activity as reference. Generalized estimation equation was used with each knee as the unit of analysis. The mean +/- SD age and percentage of female distribution was 57 +/- 12 years, 69.8% women for cases, and 46.8 +/- 15 years, 64.1% women for controls. After adjusting for age, sex, and body mass index, 2 activities were risk factors for knee osteoarthritis: prolonged squatting (odds ratio [OR] 1.51, 95% confidence interval [95% CI] 1.12-2.04) and cycling (OR 2.06, 95% CI 1.23-3.45). Knee-bending had borderline significance (OR 1.98, 95% CI 0.98-3.99). Carrying loads (OR 1.24, 95% CI 0.87-1.76) or climbing stairs (OR 0.99, 95% CI 0.69-1.42) showed no extra risk for knee osteoarthritis. Prolonged standing, sitting on the floor, and walking up/downhill were not risks for knee osteoarthritis. Housewives were at greater risk (borderline-significant) of developing knee osteoarthritis (OR 1.68, 95% CI 0.93-3.03) than women whose main occupation was outside the home. Other types of jobs and sports did not show an extra risk of knee osteoarthritis. Our findings support the role of lifestyle in the pathogenesis of knee osteoarthritis for squatting and cycling. Education on preventable risk factors should be considered in order to ensure people use knee joints appropriately and avoid overuse.

Compressive bilateral peroneal neuropathy: serial electrophysiologic studies and pathophysiological remarks.

A case of bilateral common peroneal neuropathy following prolonged squatting is reported. Serial peroneal conduction velocities with analysis of compound muscle action potential (CMAP) amplitude, area and duration performed at Days 1, 2, 5, 7, 14, 21, 37, 80 showed conduction block localized at the fibular head which lasted 14 days and paralleled clinical conditions. Axonal loss coexisted as indicated by amplitude reduction of CMAP from peroneal nerve stimulation at the ankle which reached the lowest values at Day 7. Excessive temporal dispersion, as indicated by abnormal increased duration of the CMAP from stimulation above the fibular head, was never detected. Conduction velocity in the segment across the fibular head was reduced as long as conduction block was present, due to preferential block of large diameter, fast conducting, fibers. The rapid resolution of conduction block and the absence of temporal dispersion suggest that compressive conduction block is not necessarily due to demyelination. Mechanical factors or ischemic-metabolic mechanisms might play a role.

The Relation between the Changes of Postural Achievement, Lower Limb Muscle Activities, and Balance Stability in Three Different Deep-squatting Postures

Deep squatting places a burden on the lower limb muscles and influences postural balance. We attempted to determine the effects of postural changes on the rectus femoris, tibialis anterior, gastrocnemius, soleus, and extensor digitorum brevis muscles during squatting in 8 healthy male subjects. Three squatting conditions were involved: full squatting (FS), tiptoe squatting (TT), and tiptoe squatting on a 15 degrees slope (TTS), performed randomly and recorded in a period of 4 min for each task. The influence of the squatting condition on electromyography and vertical ground reaction force parameters was examined in order to observe the effect of postural alteration on muscle activity and balance control. The results showed that the change of squatting posture from FS to TT decreased the activity of the rectus femoris and tibialis anterior muscles. FS has been suspected as a main cause of musculoskeletal complaint during prolonged squatting. In contrast, as the heel was lifted, the extensor digitorum brevis muscle increased to 39% of maximum activation. On the other hand, sway analysis at TT showed balance instability regarding the large area occupation of the center of pressure displacement. The presence of a 15 degrees slope significantly reduced the muscular load. This simple study suggests that the inclusion of a sloping surface in daily activities that requires a squatting posture would be an effective means to reduce muscular load.

Compressive Neuropathies Complicating Normal Childbirth: Case Report and Literature Review

Peroneal neuropathy has been well described in the literature, but few cases have been reported of bilateral peroneal neuropathy as a complication of normal childbirth. Most reported cases are due to prolonged squatting during childbirth, which is prevalent in certain countries. A 30-year-old woman developed bilateral footdrop shortly after normal vaginal delivery under epidural analgesics. Neurological examination and electrodiagnostic studies confirmed bilateral common peroneal mononeuropathy most likely secondary to prolonged and excessive pressure around the knees by attendants who were assisting at the delivery. The woman showed significant improvement of her symptoms after physical therapy and assisted devices. Excessive and prolonged pressure knee holding during normal childbirth may result in compressive peripheral neuropathy. Patient education and awareness among the labor and delivery team will prevent this avoidable complication.

Compressive Peroneal Neuropathy during Harvesting Season in Indian Farmers

Thirty patients (34 limbs) with compressive peroneal neuropathy induced by prolonged squatting of more than 5 h during harvesting season were treated conservatively and followed-up to an average of 28.2 months. A marked preponderance of involvement of the left side was noticed. We attribute this to the intermittent extension of the right lower limb habitually used by Indian farmers to propel themselves forwards while squatting during harvesting. All but two lesions recovered fully within 3 to 9 weeks: one patient took 16 and another 20 weeks. We recommend non-operative treatment for this benign lesion.

Mechanical injury and psychosocial factors in the work place predict the onset of widespread body pain: a two-year prospective study among cohorts of newly employed workers.

Mechanical injury has been postulated as a risk factor for widespread pain, although to date, the evidence is weak. The aim of this study was to determine whether repeated exposure to mechanical trauma in the work place predicts the onset of widespread pain and to determine the relative contribution of mechanical trauma compared with psychosocial factors. In this prospective cohort study of 1,081 newly employed subjects in 12 diverse occupational settings, we collected detailed information on mechanical exposure, posture, physical environment, and psychosocial risk factors in the work place. Study questionnaires were completed at baseline and at 12 and 24 months. Individuals free of widespread pain at baseline and 12 months were eligible for followup. Generalized estimating equations were used to determine which factors predicted the new onset of widespread pain. Of the 1,081 baseline respondents, 896 were free of widespread pain and were eligible for further study. Of these 896 subjects, 708 and 520 responded at 12 months and 24 months, respectively. The rates of new-onset widespread pain were 15% at 12 months and 12% at 24 months. Several work place mechanical and posture exposures predicted the new onset of widespread pain: lifting >15 lbs with 1 hand, lifting >24 lbs with 2 hands, pulling >56 lbs, prolonged squatting, and prolonged working with hands at or above shoulder level. Of the psychosocial exposures, those who reported low job satisfaction, low social support, and monotonous work had an increased risk of new-onset widespread pain. In multivariate analysis, monotonous work and low social support were found to be the strongest independent predictors of symptom onset. Our findings demonstrate that the prevalence of new-onset widespread pain was high, but among this young, newly employed work force, both physical and psychosocial factors played an important role.

Bilateral Peroneal Nerve Palsy Induced by Prolonged Squatting

External or internal pressures on peripheral nerves may result in compression neuropathies. Although compressive common peroneal nerve palsy is well known, to date very few cases with bilateral palsies have been reported. The clinical and electrophysiological manifestations of three patients with bilateral peroneal nerve palsies are reported, and their clinical outcomes are discussed. The first patient's transient bilateral palsy was corrected by conservative means. The second patient, with a more severe axonal lesion, did not improve within 3 months, and nearly complete recovery occurred after operative decompression. For the third patient, who had been suffering for a long time, no improvement could be hoped for. Prolonged squatting was the etiological factor in all three cases. Bilateral compression neuropathies of the peroneal nerve, like unilateral lesions, may recover spontaneously. Surgical intervention is recommended for patients with predominantly axonal lesions and for those who do not improve within 3 months.

Common Peroneal Neuropathy Secondary to Squatting during Childbirth

Background: Common peroneal neuropathy occurs fairly frequently in the adult population; however, very few cases of peroneal neuropathy after prolonged squatting have been reported.Case: A 29-year-old woman noted right foot numbness and weakness immediately after childbirth, which involved 15–30 minutes of pushing in a squatting position. Physical examination and an electrodiagnostic study confirmed a common peroneal neuropathy. The patient was referred for rehabilitation, including bracing and gait training, which improved substantially her mobility and function.Conclusion: Prolonged squatting should be minimized or avoided. A high index of suspicion for peroneal neuropathy after prolonged squatting must be present. Early diagnosis and treatment may limit the number of complications in these patients, particularly falls.