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Peroneal Nerve Entrapment

Peroneal nerve entrapment is the most common nerve entrapment syndrome in the lower limbs and can affect the movement and senses of the foot.  If not treated properly it can lead to long-term problems.
Cause of Peroneal Nerve Entrapment
Peroneal nerve entrapment occurs when the space around the perineal nerve becomes congested. This usually occurs when the nerve is being squashed at the head of the fibula (the bony nodule at the side of your leg just below the knee).
The pathway of the perineal nerve
To understand the symptoms of the entrapment of the common peroneal nerve it is important to understand the pathway of this nerve. The common peroneal nerve emerges from the bifurcation (separation) of the sciatic nerve, (the longest nerve in your body which runs at the back of the legs)at the level of the knee around the head of the fibula). 
The common peroneal nerve then splits into the:
Superficial perineal nerve- The nerve which runs at the side of the lower leg causing your foot to rotate outwards (exertion)
The deep perineal nerve which causes you to move your ankles so your toes are pointing upwards.
Problems to the common perineal nerve can therefore effect movement.
Symptoms are usually neurological as it is the nerves which are affected:
  • Reduced sensation in the lower leg
  • Reduced ability to point toes upwards (dorsiflexion) and rotate foot outwards (evertion)
  • Foot drop- The inability to prevent toes dragging on the floor when walking
  • Numbness
Risk factors
  • Sitting on your knees can squash the common perineal nerve
  • Tightness of the peroneal muscles and the tibias anterior (the muscle at the front of your shin
  • Sitting crossed legged
  • Ankle sprains- Sprains can outside ankle can cause an excessive stretch of the nerves as the foot twists inwards
  • Dislocation of the knee joint
  • Direct trauma
  • Nerve traction- when nerves are overstretched
  • Fractures
PhysiotherapyPhysiofriend helps to treat client with common pereroneal nerve entrapment symptoms using the correct management, advice and exercises.
Heat and cold- Ice is useful for reducing the amount of pain and inflammation that occurs during acute injuries or during a flare up. It is never good to place ice directly on the skin as this can cause skin and nerve damage. During icing skin integrity should be checked every 5 minutes and ice should not be applied for more than 10 minutes at a time and up to about 3-5X daily.
Heat is good for muscles in conditions which are more chronic or past the first 3-5 days of an acute injury. Heat should never be placed on an area that looks inflamed and swollen as this will make the condition worse. 
Massage- Massage helps to reduce the amount of tight muscle affecting the lower limb such as the muscle at the front of your shin (the tibias anterior) and the muscles at the side of your leg (the common perineal muscles).
Stretching- Stretching similar to massage helps to reduce tightness in the affected areas by stretching the muscle fibres. Stretching should be done regularly to gain benefits. 
Neurodynamic exercises: The nerves like any other tissue in our body does not like to be restricted as this is likely to cause neurological symptoms. Neurodynamic exercises helps to mobilise and free trapped nerves.
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