Conservative treatment of bilateral sural nerve entrapment in an ice hockey player

Abstract

Midway through the season, an intercollegiate ice hockey player experienced bilateral numbness in the posterior aspect of the leg along the area of the calcaneal tendon. This numbness corresponded with the distribution of both sural nerves. While obtaining a history of the condition, the athlete admitted that he routinely spiraled his ice hockey laces tightly around the proximal portion of each ice hockey boot before finally tying the laces off. A complete neurological examination was negative except for the bilateral numbness. Based upon this information, a diagnosis of bilateral sural nerve entrapment was made. In addition to frequent follow-up examinations, nonoperative treatment consisted of changing the way the athlete laced his ice hockey skates. The athlete was able to complete the season and, after approximately 4 months, was asymptomatic. Although this appears to be an isolated incident, athletic trainers should be cautious when evaluating patients with paraesthesia in this region. If symptoms such as those described develop, entrapment of the sural nerve should be considered as a possible cause.