Neuropathies of the foot and ankle in athletes

Abstract

Although neuropathies in the athlete's foot and ankle are uncommon, they are often underdiagnosed. This is primarily due to the complex interplay of factors that are required for their presentation. The most frequently encountered entrapment syndromes (in decreasing order) involve the interdigital nerves, first branch of the lateral plantar nerve, isolated medial or lateral plantar nerves, posterior tibial nerve, deep peroneal nerve, superficial peroneal nerve, sural nerve, and saphenous nerve. A thorough knowledge of peripheral nerve anatomy is essential in establishing the diagnosis. Roentgenograms may reveal bony abnormalities that are the diagnosis. Roentgenograms may reveal bony abnormalities that are commonly contributory. Electrodiagnostic tests may be normal because these dynamic syndromes often resolve at rest. In most cases, correction of underlying etiologies combined with rest, NSAIDs, and occasionally injections will allow resolution of the syndrome. Recalcitrant cases may require surgical decompression, which frequently provides satisfactory results.