Lower Limb Surgery | Medial Plantar Nerve Entrapment (Jogger’s Foot) (2023)

■■■Description

Medial plantar nerve entrapment is a nerve disorder in thefoot that causes pain and occasionally loss of feeling in the foot involving the first (big) and second toes. It involves compression of the medial plantar nerve in the mid-foot near the bottom of the arch by ligament-like tissues.

■■■Common Signs and Symptoms
  • Tingling, numbness, or burning from the arch of the footand traveling to the first (big) and often second toes

  • Pain and tenderness along the arch of the foot, worsened by standing on the tiptoes of the affected foot or after running

  • A feeling of the ankle giving way

  • Symptoms that are worse (and sometime only present)during and after running on level ground

■■■Causes
  • Pressure on the medial plantar nerve at the arch of thefoot ankle caused by ligament-like tissue that covers and pinches the nerve

■■■Risk Increases With
  • Recurrent ankle sprains

  • Sports that involve a lot of running, particularly distancerunning

  • Direct pressure on the nerve, such as with tight-fittingshoes, shoes with minimal padding, and loss of shockabsorption or use of new arch supports (orthotics)

  • Looseness of the joints of the foot, flat feet, or stiffness ofthe big toe (hallux rigidus)

  • New arch supports that have high arches

  • Medical disorders, including diabetes mellitus and thyroiddisorders

■■■Preventive Measures
  • Maintain appropriate conditioning:

    • Foot and ankle flexibility

    • Muscle strength and endurance

      (Video) Endoscopic Plantar Fascia Release

    • Cardiovascular fitness

  • Use proper equipment, such as shoes and orthotics, and ensure correct fit.

  • Taping, protective strapping, bracing, or high-top tennis shoes may help prevent ankle sprains and nerve stretching injury.

■■■Expected Outcome

This condition is usually curable with appropriate treatment,and sometimes it heals spontaneously. Occasionally, surgery is necessary.

■■■Possible Complications
  • Permanent numbness in the foot and toes

  • Persistent pain in the foot or ankle

  • Inability to compete due to pain

■■■General Treatment Considerations

Initial treatment consists of rest from the offending activity and medications and ice to help reduce inflammation and pain. Removal of new arch supports or smaller, soft arch supports may be recommended if this is felt to be the cause of this problem. Cross-training or reducing the amount of running is usually of benefit. Stretching and strengthening exercises of the muscles of the foot and ankle may be useful. If this treatment is not successful, surgery may be necessary to free the pinched nerve. This provides almost complete relief, with full return to sporting activities in most patients. Training, while wearing orthotics, usually begins 6 weeksafter the surgery.

■■■Medication
  • Nonsteroidal anti-inflammatory medications, such as aspirinand ibuprofen (do not take within 7 days before surgery), or other minor pain relievers, such as acetaminophen, are often recommended. Take these as directed by your physician. Contact your physician immediately if any bleeding, stomach upset, or signs of an allergic reaction occur.

  • Pain relievers may be prescribed as necessary by your physician, usually only after surgery. Use only as directed and only as much as you need.

(Video) Medial plantar nerve slider: neural mobilization technique

■■■ Heat and Cold

  • Cold is used to relieve pain and reduce inflammation foracute and chronic cases. Cold should be applied for 10 to 15 minutes every 2 to 3 hours for inflammation and pain and immediately after any activity that aggravates your symptoms. Use ice packs or an ice massage.

  • Heat may be used before performing stretching and strengthening activities prescribed by your physician, physical therapist, or athletic trainer. Use a heat pack or a warm soak.

■■■ Notify Our Office If

  • Symptoms get worse or do not improve in 2 weeks despitetreatment

  • New, unexplained symptoms develop (drugs used intreatment may produce side effects)

➢RANGE OF MOTION AND STRETCHING EXERCISES•Medial Plantar Nerve Entrapment (Jogger’s Foot)

These are some of theinitialexercises you may start your rehabilitation program with until you see your physician, physical therapist, or athletic trainer again or until your symptoms are resolved. Please remember:

  • Flexible tissue is more tolerant of the stresses placed on it during activities.

  • Each stretch should be held for 20 to 30 seconds.

  • Agentlestretching sensation should be felt.

STRETCH•Gastrocsoleus

  1. Standonearm length from the wall as shown. Place calf muscle to be stretched behind you as shown.

  2. Turn thetoes inandheel outof the leg to be stretched.

  3. Lean toward wall leading with your waist, allowing yourarms to bend.Keep your heel on the floor.

  4. First do this exercise with the knee straight, then bend theknee slightly. Keep your heel on the floor at all times.

  5. Hold this position for seconds.

  6. Repeat exercise times,times per day.

RANGE OF MOTION•Toe Extension

  1. Grip your toe(s) as shown in the drawing.

  2. Pull the toe(s) up toward your body as shown. Repeat thisexercise by pulling the toe down.

  3. Hold this position for seconds.

  4. Repeat exercise times,times per day.

    (Video) Tibial nerve, Common Fibular Nerve & Plantar nerve - Real Time Cadaveric Anatomy

STRETCH•Gastrocsoleus

Note:This exercise can place a lot of stress on your foot and ankle and should only be done after specifically checking with your physician, physical therapist, or athletic trainer.

  1. Place your toes and the ball of your foot on a book(s) or theedge of a stair. Your heel should be off the ground.

  2. Hold on to a chair or stair rail for balance.

  3. Allow your body weight to stretch your calf.

  4. First do this exercise with the knee straight, then bend theknee slightly.

  5. Hold this position for seconds.

  6. Repeat exercise times, times per day.

RANGE OF MOTION•Ankle Eversion

  1. Sit with yourleg crossed over the other.

  2. Grip the foot with your hands as shown and turn the sole of your foot upward and out so that you feel a stretch onthe inside of the ankle.

  3. Hold this position for seconds.

  4. Repeat exercise times,times per day.

FLEXIBILITY•Hamstrings

  1. Lie on your back with your leg bent and both hands holding on to it behind the thigh as shown.

  2. Your hip should be bent to90 degreesand the thigh pointing straight at the ceiling.

  3. Straighten out your knee as far as you can. Keep your thigh pointing straight toward the ceiling.

  4. Keep the other leg flat on the floor.

  5. Hold this position for seconds.

  6. Repeat exercise times,times per day.

FLEXIBILITY•Hamstrings, Ballet

  1. Stand and prop the leg you are stretching on a chair, table, or other stable object.

  2. Place both hands on the outside of the leg you are stretching.

  3. Make sure that your hips/pelvis are also facing the leg you are stretching.

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  4. Slide your hands down the outside of your leg.

  5. Lead with your chest/breast bone. Keep your chest upright and back straight. Do not hunch over at the shoulders. Keep your toes pointing up.

  6. You should feel a stretch in the back of your thigh.

  7. Hold this position for seconds.

  8. Repeat exercise times,times per day.

➢STRENGTHENING EXERCISES•Medial Plantar Nerve Entrapment (Jogger’s Foot)

These are some of theinitialexercises you may start your rehabilitation program with until you see your physician, physical therapist, or athletic trainer again or until your symptoms are resolved. Please remember:

  • Strong muscles with good endurance tolerate stress better.

  • Do the exercises asinitiallyprescribed by your physician, physical therapist, or athletic trainer. Progress slowly with each exercise, gradually increasing the number of repetitions and weight used under their guidance.

STRENGTH•Towel Curls

  1. Sit in a chair and place a towel on a noncarpeted floor. Place your foot/toes on towel as shown. (You may also stand to do this exercise rather than sit.)

  2. Curl/pull towel toward you with your toes while keeping your heel on the floor. Move towel with toes only. Do not move your knee or ankle.

  3. If this is too easy, place a light weight (book, hand weight, etc.) at the far end of the towel.

  4. Repeat exercise times, times per day.

STRENGTH•Ankle Eversion

  1. Attach one end of elastic band to fixed object or leg of table/desk. Loop the opposite end around your foot.

  2. Turn your toes/foot outward as far as possible, attempting to pull your little toe up and outward. Hold this position forseconds.

  3. Slowly return to starting position.

  4. Repeat exercisetimes, times per day.

STRENGTH•Ankle Inversion

  1. Attach one end of elastic band to fixed object or leg of table/desk. Loop the opposite end around your foot.

  2. Turn your toes/foot inward as far as possible, attempting to push your little toe down and in. Hold this position for seconds.

  3. Slowly return to starting position.

  4. Repeat exercise times, times per day.

FAQs

What is jogger's foot? ›

Jogger's foot is another term for medial plantar neuropraxia, an injury in which the medial plantar nerve that gives sensation to the bottom of the foot becomes compressed due to repetitive injury to the area. As its name suggests, jogger's foot usually affects joggers, as well as long distance and marathon runners.

What is plantar nerve entrapment? ›

Medial and lateral plantar nerve entrapment is compression of nerve branches at the inner heel (the medial or lateral branches of the plantar nerve) that causes pain. The nerve branches are pinched (compressed) between bone, ligaments, and other connective tissues, causing pain.

How do you fix Baxter's nerve entrapment? ›

Podiatry treatment for Baxter's nerve entrapment
  1. Foot strapping.
  2. Orthotics to address foot mechanics.
  3. Stretching and strengthening programs.
  4. Footwear advice and modification.
  5. Rest, ice and activity modification.
  6. Oral medications (such as NSAIDs)
  7. Ultrasound therapy and heat.

Can surgery fix nerve entrapment? ›

When physical therapy and other forms of non-surgical treatment fail, nerve entrapment surgery is the best option to restore function and alleviate pain. There are two types of ulnar nerve entrapment surgery: At the elbow. Your surgeon will make an incision at the elbow and perform a nerve decompression.

Does nerve entrapment require surgery? ›

You might need surgery if you have severe or long-standing ulnar nerve entrapment. This can occur as the result of strain caused by repetitive movements with your arm or hand. Bending your elbow stretches your ulnar nerve behind the bump of your funny bone and keeping it bent for extended periods can cause irritation.

How do you treat jogger's toes? ›

Runner's Toe Treatment

If you have runner's toe, they will do a procedure called nail trephination. Nail trephination involves draining the pooled blood by drilling a small hole into the nail with a heated needle or carbon dioxide laser. They will give you local anesthetic first so it doesn't hurt.

What causes runners foot? ›

Excess sweat and wetness in the shoe cause the skin to soften, leaving high-pressure areas at risk. Wearing the right running shoes can help you avoid friction and blisters. Damaged Toenails – If your toe rubs against the front of the shoe, it can cause the nail to be pushed down and become bruised.

How do you get rid of runners feet? ›

Here are some preventive steps to take:
  1. Buy properly fitting shoes. It's a good idea to buy shoes loose enough to give your toes room to move but not so loose that your foot slides in the shoe. ...
  2. Keep your toenails short. ...
  3. Work on your technique. ...
  4. Tie your shoes. ...
  5. Slowly increase mileage. ...
  6. Wear cushioning socks.
Jan 8, 2021

Is nerve entrapment permanent? ›

While ulnar nerve entrapment is usually not serious, it can have permanent consequences without prompt treatment, including paralysis and loss of feeling in the affected hand or arm. However, with proper diagnosis and treatment, most people with ulnar nerve entrapment can make a full recovery.

Does nerve entrapment get worse? ›

These symptoms may get worse when you do activities that pull or press on the nerve. Nerve compression syndromes cause a variety of symptoms depending on which nerve it affects. You may experience: Pain, numbness or tingling in the area of compression (usually a joint like your wrist, elbow or ankle).

Is nerve entrapment a disability? ›

The Social Security Administration recognizes the negative impact nerve root compression can have on an individual's ability to work, which is why it is considered a disability eligible for social security disability benefits.

How painful is nerve entrapment? ›

"Nerve entrapment usually isn't a serious condition if it doesn't cause pain or weakness," Dr. Hoke says. "On the other hand, some people have extreme pain, even though the actual compromised nerve measured by nerve conduction studies is only mildly entrapped," he says.

What does Baxter's nerve entrapment feel like? ›

The symptoms of Baxter's nerve entrapment often include: A sharp/burning pain around the inner aspect of the heel. Pins and needles around the inner aspect or under the heel, especially when the nerve is knocked or tapped. Pain when you touch the inside of the heel.

What are the signs and symptoms of deep peroneal nerve entrapment? ›

  • Inability to point the toes upward or lift the ankle up (dorsiflexion)
  • Pain, weakness or numbness affecting the shin or the top of the foot.
  • Loss of ability to move the foot.

What kind of doctor treats nerve entrapment? ›

Neurologists are specialists who treat diseases of the brain and spinal cord, peripheral nerves and muscles.

What is the recovery time for nerve surgery? ›

If your nerve is bruised or traumatized but is not cut, it should recover over 6-12 weeks. A nerve that is cut will grow at 1mm per day, after about a 4 week period of 'rest' following your injury.

How successful is nerve surgery? ›

Nerve Transfer Success Rate

Success depends on the type and severity of your nerve injury and the skills and experience of your surgical team. Between 80% and 90% of patients with brachial plexus injuries tend to experience significant improvement after a nerve transfer.

Do they put you to sleep for nerve surgery? ›

We give all patients sedating medicine when we do the nerve block to help you relax. Will I be awake during the operation? After a nerve block, the part of your body that will be operated on will be numb. Many times it is your choice to be as awake or asleep as you want.

Is nerve surgery painful? ›

You're normally under general anesthesia for nerve repair surgery, so you'll feel no pain during the procedure. Your surgeon examines the injured nerve using a powerful microscope and debrides torn tissue or scar tissue from the ends.

What is the most common nerve entrapment? ›

Carpal tunnel syndrome is the most common type of entrapment neuropathy. It involves compression of the median nerve, which runs through the arm and controls movement in the thumb and first three fingers (all but the pinky).

How long does joggers toe last? ›

The nail may fall off any time up to 6 months. If, and when, the nail falls off, you want to ensure that you clean the area with soap and water twice a day, and cover it with a bandage for protection while it heals.

When does runners toe go away? ›

How long does it take for Runner's toe to heal? While the pain can often be relieved immediately by decreasing the pressure by draining the blood, it may continue to be sore for a couple days. However it may take as long as a year for the toenail to grow out and replace itsself .

What does runners toe look like? ›

Your toenail may start to look black, dark red or blue, because of bleeding or bruising beneath it. Your toenail may become thicker. This happens because pressure under the nail can pull it away from its bed.

Why do the bottom of my feet hurt when I walk? ›

Pain in the bottom of your foot is often caused by exercise, such as running, wearing shoes that are too tight or a condition, such as Morton's neuroma. Some people also have a foot shape that puts extra pressure on the bottom of the foot. Hard or cracked skin or a verruca can also cause this type of pain.

Why do runners remove their toenails? ›

Toenails turn black and blue from friction and wear -- from rubbing against the sock or from hitting the toe or even the top of the sneaker. Blood can accumulate underneath the nail and lift the nail off the nail bed, making the nail prone to falling off.

Why do runners feet swell? ›

Runners' feet may swell both during and after runs for a number of reasons. First, tight and restrictive running shoes can contribute to swelling. Since ill-fitting shoes often squeeze the toes and heels, muscles in the feet become overwhelmed in trying to maintain balance while running, resulting in swelling.

Does Athletes foot ever completely go away? ›

“One of the most common misconceptions about athlete's foot is that people think that it will go away on its own,” explained Dr. D'Angelantonio. Unfortunately, athlete's foot does not usually heal on its own.

Does Athletes foot ever go away on its own? ›

Athlete's foot is unlikely to get better on its own, but you can buy antifungal medicines for it from a pharmacy. They usually take a few weeks to work. Athlete's foot treatments are available as: creams.

Does Athletes foot ever go away? ›

Most mild cases of athlete's foot clear up within 2 weeks. But treatment can go for several weeks or longer if the infection is more serious or affects the toenails.

Can an MRI show nerve entrapment? ›

MR imaging may allow early recognition of suprascapular nerve entrapment, by detecting clinically unsuspected masses, as well as indirect signs of nerve denervation in suprascapular nerve syndrome [7, 8].

Does massage help nerve entrapment? ›

The answer is yes! By applying pressure to the pinched nerve, it can help relieve tension, reduce pain and inflammation and promote circulation. It will also help relax you, your muscles and the affected area as well.

How long can a nerve be compressed before permanent damage? ›

Depending on its location and severity, a pinched nerve may last for a few days, several weeks, or even longer than that. In the most severe cases, recurring compression against the nerve may result in permanent damage.

Is heat or ice better for nerve entrapment? ›

So, you may be wondering which is better for a pinched nerve, heat or ice? The answer is both. Using heat and ice for a pinched nerve is a good way to reduce swelling, promote fresh blood flow to the area, and relax the surrounding muscles that may be contributing to the pinched nerve.

At what point is nerve damage permanent? ›

As a specialist in peripheral nerve surgery, Dr. Seruya wants his patients to know that after a period of 12-18 months nerve damage can become permanent.

How do you Untrap a nerve in your foot? ›

Home remedies
  1. Rest up. Try to avoid any movements or activities that aggravate the pinched nerve.
  2. Adjust your footwear. Make sure your shoes fit well and provide support. ...
  3. Apply ice. ...
  4. Try massage. ...
  5. Use a brace. ...
  6. Take over-the-counter (OTC) medications.

Is nerve damage a permanent disability? ›

Depending on the extent of damage to the nerve, it can heal on its own or become permanent, even with treatment. If you suffer from a condition that causes nerve damage that is so severe that it impacts your ability to work for at least a year, you may be eligible to receive Social Security Disability benefits.

Can you get disability for neuropathy in your feet? ›

The Social Security Administration (SSA) recognizes both peripheral neuropathy and diabetic neuropathy as potentially disabling conditions that may qualify applicants to received SSDI benefits.

How do you prove nerve damage? ›

In order to fully determine the extent of the damage to the nerve, the doctor may order an electrical conduction test to determine the passage of electrical currents through the nerves. Two of these tests are electromyography and nerve conduction velocity.
...
Diagnosis of Peripheral Nerve Injury
  1. CT scan.
  2. MRI.
  3. MRI neurograph.

Does stretching help nerve entrapment? ›

Severe cases may require medical care but for many patients, gentle exercises that target the affected area can help relieve minor nerve pain. These stretches lessen the pressure placed on the nerve and loosen the surrounding muscles. Plan to make these exercises part of your daily routine, two or three times per day.

What are three signs when nerve compression occurs? ›

redness, swelling, and inflammation. aches and pain. tingling or numbness. muscle weakness.

Can a trapped nerve Untrap? ›

The sooner you receive a diagnosis and treatment for your pinched nerve, the faster you will find relief. In some instances, the damage resulting from a pinched nerve is irreversible. You can generally relieve your symptoms including pain with treatment.

How do you fix nerve entrapment in the foot? ›

Foot and ankle neuropathy and nerve entrapment treatment
  1. Icing—Icing can relieve swelling and inflammation to help the nerve heal.
  2. Massage—Massage can relieve compression of the nerve and help with pain.
  3. Anti-inflammatory medicines—Medicines available over the counter or by prescription can reduce inflammation and pain.

How do you treat plantar nerve entrapment? ›

Medial and lateral plantar nerve entrapment is symptomatic compression of the medial and/or lateral branches of the posterior tibial nerve at the medial heel and proximal arch. Diagnosis is clinical. Treatment involves orthotics and immobilization.

What can be done for nerve entrapment? ›

The most frequently recommended treatment for a pinched nerve is rest for the affected area. Your doctor will ask you to stop any activities that cause or aggravate the compression. Depending on the location of the pinched nerve, you may need a splint, collar or brace to immobilize the area.

How long does it take for deep peroneal nerve to heal? ›

If you have surgery for a peroneal nerve injury, recovery time varies. Generally, you'll limit activities for the first six weeks after surgery. After six weeks, you can start increasing activity levels slowly. Full recovery usually takes around three to four months.

What causes deep peroneal nerve entrapment? ›

[1] ATTS, also known as deep peroneal nerve (DPN) entrapment, is a compression neuropathy of the DPN most commonly caused by the tight fascia band in the anterior ankle called the inferior extensor retinaculum.

How do you Unpinch a nerve in your foot? ›

Icing of the painful area to relieve swelling and pain. Over-the–counter anti-inflammatory medications, such as ibuprofen, to reduce pain and swelling. Massaging of the affected area to stimulate the nerve tissue and promote healing.

How long does it take for nerve entrapment to heal? ›

With rest and other conservative treatments, most people recover from a pinched nerve within a few days or weeks. Sometimes, surgery is needed to relieve pain from a pinched nerve.

How can I Untrap a trapped nerve? ›

Ways to Treat a Pinched Nerve At Home
  1. Resting the Affected Area. When you have a pinched nerve giving yourself time to rest is important. ...
  2. Applying Ice. ...
  3. Using Heat Therapy. ...
  4. Stretching and Exercises. ...
  5. Physical Therapy. ...
  6. Chiropractic Care. ...
  7. Massage Therapy.
May 31, 2022

Is walking good for nerve pain in feet? ›

Walking can reduce the pain and other symptoms of neuropathy from the nerve damage in your feet and lower legs. Walking and other light aerobic exercises have various benefits for people affected by neuropathy, which is a wide range of conditions involving disease and damage to the peripheral nerves.

How long does it take for nerves to heal after foot surgery? ›

It is not uncommon to experience some shooting nerve pain after surgery it will usually diminish in intensity and frequency every few days but can last up to 4-6 weeks.

What are the symptoms of nerve damage in foot? ›

The main symptoms of peripheral neuropathy can include:
  • numbness and tingling in the feet or hands.
  • burning, stabbing or shooting pain in affected areas.
  • loss of balance and co-ordination.
  • muscle weakness, especially in the feet.

Is heat or ice better for nerve pain? ›

Nerve Pain

It's best to use cold when the pain is still sharp and move on to heat once that sharpness has subsided. The heat will increase blood flow and help tissues heal faster.

Is heat good for a trapped nerve? ›

Apply heat

The heat will relax the muscles that might be tight around a pinched nerve. Heat also increases blood flow, which can help the healing process.

Can a trapped nerve be released by massage? ›

Yes, absolutely! They often provide an immediate form of pain relief, due to their effectiveness at relaxing muscles. Massage for trapped nerves works well because it allows a person to relax and lie still for some time, meaning their cortisol drops, which then allows the muscles to relax and repair more easily.

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