Lower Extremity Neuropathies in Athletes

Lower extremity neuropathies are an important and often underrecognized cause of pain and dysfunction in athletes. While classic neuropathic symptoms such as numbness, paresthesias, and weakness in the distribution of the affected peripheral nerve may be present, clinical presentations are frequently subtle and nonspecific. On physical examination, clinicians may identify focal neurological deficits, a positive Tinel sign at the site of suspected compression, and symptom reproduction with provocative maneuvers. Diagnostic evaluation may include electromyography/nerve conduction studies, as well as imaging modalities such as radiographs, ultrasound, and magnetic resonance imaging, to support the diagnosis. Initial management is typically nonoperative, although surgical intervention may be considered for persistent or progressive symptoms. This article provides an updated review of the evaluation and management of common lower extremity neuropathies in athletes.