Peripheral nerve compression in the lower limbs of athletes – clinical, diagnostic, and therapeutic aspects

Abstract

Background. Peripheral nerve compression is a common yet frequently overlooked cause of lower limb pain in athletes. Without timely diagnosis, it can delay return to sport. The underlying mechanisms include repetitive microtrauma, anatomical variations, and both external and internal sources of compression. Objective(s). To analyze peripheral compression neuropathies in athletes, diagnostic methods, and therapeutic strategies, with particular focus on enabling a swift return to athletic performance. Materials and methods. A literature review and synthesis of scientific sources addressing the anatomy and pathophysiology of peripheral nerves, as well as the interpretation of documented symptoms of the most common peripheral neuropathies in the lower limb among athletes, were carried out through the consultation of search sources such as PubMed and MedScape. Results. The most frequently identified neuropathies affected the common peroneal nerve (dorsiflexion weakness, dorsal foot paresthesia), deep peroneal nerve (anterior tarsal tunnel syndrome), superficial peroneal nerve (entrapment in the distal third of the leg), posterior tibial nerve (tarsal tunnel syndrome), sural nerve (posterolateral ankle pain), and plantar digital nerves (Morton's neuroma). Imaging studies revealed morphological alterations of the affected nerves, while electrodiagnostic evaluations allowed differentiation between demyelinating and axonal damage and provided insights into the severity and chronicity of the condition. Conclusion(s). Peripheral nerve compressions are often underdiagnosed in athletes. Accurate diagnosis requires a thorough clinical evaluation supported by imaging and electrodiagnostic testing. Improved awareness and timely management can accelerate recovery and optimize the return to athletic activity.