Sports Neuropathy Recovery with Effective Treatments

Sports Neuropathy Recovery With Integrative Chiropractic Care and Regenerative Therapies

Abstract

Yes, neuropathies can occur in sports. Athletic nerve injuries may develop from repeated pressure, stretching, direct impact, joint injuries, tight equipment, or repetitive movement. Symptoms can include burning pain, tingling, numbness, weakness, loss of grip, foot drop, or pain that appears only during activity. Because nerve symptoms can look like tendon, muscle, or joint injuries, sports neuropathies are sometimes missed.

Treatment usually begins with identifying what is irritating the nerve and resolving that problem. An integrative plan may combine rehabilitation, chiropractic care, movement correction, medical evaluation, and selected technologies such as laser therapy. In certain cases, ultrasound-guided injections or hydrodissection may also be considered. Regenerative treatments are being studied, but their role in directly treating sports neuropathy is still developing.

At Injury Medical Clinic PA in El Paso, Texas, Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, works within a multidisciplinary model that combines chiropractic care, rehabilitation, functional medicine, personal injury care, and medical oversight from Maria Guadalupe Cardenas, MD. This approach looks at both the mechanical and biological factors that may affect nerve recovery.

Are There Neuropathies in Sports?

Yes. Sports neuropathies are injuries or disorders affecting peripheral nerves during athletic activity.

Research has described sports-related nerve problems for decades. Peripheral nerve injuries may result from:

• Repetitive microtrauma
• Direct blows
• Stretching of a nerve
• Joint dislocations
• Bone fractures
• Muscle swelling or hypertrophy
• Scar tissue
• Poor movement mechanics
• Tight shoes, boots, braces, or other sports equipment
• Repeated sport-specific positions

Chronic injuries caused by repeated stress are often more common than severe acute nerve injuries. Mitchell et al. (2014) explained that athletes can develop nerve problems from repetitive compression or stretching related to the movements required by their sport. These injuries may also be overlooked because the symptoms can resemble more common muscle, tendon, ligament, or joint problems.

An early study by Hirasawa and Sakakida (1983) also found that continuous compression and repeated trauma were important causes of sports-related peripheral nerve injuries.

What Is Sports Neuropathy?

A nerve problem does not always cause sharp pain. Sometimes the first sign is a strange feeling that occurs while running, throwing, cycling, lifting, or playing another sport.

Common symptoms can include:

• Burning pain
• Pins and needles
• Tingling
• Numbness
• Electric or shooting pain
• Unusual skin sensitivity
• Muscle weakness
• Loss of grip strength
• Poor coordination
• Foot weakness or foot drop
• Symptoms that worsen during activity
• Pain that follows the path of a specific nerve

A 2025 review of upper-extremity neuropathies in athletes noted that symptoms can sometimes be subtle and nonspecific. Examination may reveal weakness, altered sensation, a positive Tinel sign, or symptoms that appear when the affected nerve is placed under stress (Stokes et al., 2025).

Which Nerves Can Be Injured in Sports?

The nerve involved often depends on the sport.

Shoulder and Arm

Throwing, contact sports, weight training, gymnastics, and racket sports may affect nerves such as the:

• Brachial plexus
• Suprascapular nerve
• Axillary nerve
• Radial nerve
• Median nerve
• Ulnar nerve

For example, repetitive throwing can irritate nerves around the shoulder and elbow. Cyclists may develop ulnar nerve compression at the hand from long periods of pressure on the handlebars.

Knee, Leg, Ankle, and Foot

Runners and athletes who repeatedly load the legs may experience irritation of the:

• Common fibular or peroneal nerve
• Tibial nerve
• Deep fibular nerve
• Superficial fibular nerve
• Sural nerve
• Medial plantar nerve
• Interdigital nerves

Foot and ankle nerve entrapments can result from abnormal gait mechanics, sports activities, trauma, ankle instability, swelling, and repetitive compression (Senk & Carlson, 2026).

Sural nerve neuropathy is one example. The sural nerve travels down the outer part of the lower leg toward the lateral foot. It can become irritated after an ankle sprain, repeated running, scar formation, or compression from tight ski boots and other equipment. Symptoms may include burning, tingling, or pain along the outside of the calf and foot.

Why Diagnosis Matters

Athletes often continue training through pain. That can become a problem when the pain comes from a nerve.

Early diagnosis matters because long-lasting compression can eventually interfere with normal nerve signaling.

Evaluation may include:

• Medical and injury history
• Neurological examination
• Muscle strength testing
• Reflex testing
• Sensory testing
• Gait and movement analysis
• Orthopedic examination
• Nerve tension tests
• Electromyography, or EMG
• Nerve conduction studies
• Diagnostic ultrasound
• MRI or MR neurography

MRI can show changes within an injured nerve and surrounding muscles. High-resolution ultrasound can also identify swelling, compression, abnormal nerve movement, or structures pressing against a nerve (Mitchell et al., 2014; Senk & Carlson, 2026).

Progressive weakness, major loss of sensation, muscle wasting, foot drop, or neurological problems following major trauma should receive prompt medical evaluation.

Integrative Chiropractic Care and Sports Neuropathy

Chiropractic treatment does not replace neurological testing or medical treatment when a serious nerve injury is present. Its role focuses on the mechanical environment surrounding the irritated nerve.

An integrative chiropractic evaluation may look at:

• Spinal and joint mobility
• Posture
• Muscle imbalance
• Gait
• Foot and ankle mechanics
• Shoulder blade movement
• Hip movement
• Scar and soft-tissue restrictions
• Training technique
• Nerve mobility

Treatment may include carefully selected joint manipulation or mobilization, soft-tissue techniques, exercise, nerve-gliding exercises, and movement retraining.

For example, if repeated ankle instability changes an athlete’s gait and increases tension around a peripheral nerve, restoring ankle function and retraining movement may reduce a mechanical factor contributing to irritation.

The American Academy of Physical Medicine and Rehabilitation also recognizes functional rehabilitation, footwear modification, orthotics, technique modification, and correction of mechanical contributors as important parts of managing certain foot and ankle nerve entrapments.

Rehabilitation Helps the Nerve and the Athlete

Rest alone is not always enough.

Once serious injury has been ruled out, rehabilitation may gradually restore:

• Range of motion
• Muscle strength
• Joint stability
• Balance
• Proprioception
• Nerve mobility
• Running or throwing mechanics
• Sport-specific movement

Radić et al. (2018) described physical therapy and functional rehabilitation as major parts of conservative treatment for many sports-related nerve injuries.

The goal is not simply to reduce pain. The athlete must also correct the movement or loading pattern that helped create the nerve irritation.

Laser Therapy as an Adjunct

Photobiomodulation, often called therapeutic laser therapy, is another option sometimes added to rehabilitation.

Research on photobiomodulation suggests that light-based therapy may influence inflammation, pain signaling, cellular metabolism, and nerve function. A systematic review involving diabetic peripheral neuropathy found improvements in neuropathic pain and some nerve-conduction measurements. However, diabetic neuropathy is different from a sports-related entrapment injury, so these results cannot automatically be applied to every athlete.

Laser therapy should therefore be viewed as an adjunct, not a replacement for finding and correcting nerve compression, instability, poor mechanics, or another structural cause.

What About Shockwave Therapy?

Extracorporeal shockwave therapy is commonly used for musculoskeletal problems such as some chronic tendon disorders. Researchers are also studying its effects on nerves.

A 2024 systematic review found that shockwave treatment produced changes in some sensory nerve-conduction measurements. However, the authors also stated that peripheral nerve applications remain an area requiring additional research.

Studies involving carpal tunnel syndrome have produced mixed results. Some reviews report improvement, while others demonstrate only limited or temporary benefits.

For this reason, shockwave therapy should be selected based on the exact diagnosis rather than used automatically whenever an athlete reports nerve pain.

Precision Injections and Nerve Hydrodissection

One of the more interesting developments in nerve treatment is ultrasound-guided hydrodissection.

Instead of blindly placing a needle near a painful area, ultrasound allows a trained medical professional to see the nerve and nearby tissues in real time.

Hydrodissection uses fluid to gently separate an entrapped nerve from surrounding fascia, scar tissue, or other structures.

Injectates studied include:

• Saline
• Local anesthetic
• Corticosteroid
• 5% dextrose
• Platelet-rich plasma, or PRP

A systematic review found encouraging outcomes with ultrasound-guided hydrodissection, including studies using dextrose and PRP. However, most of the research involved carpal tunnel syndrome rather than athletic neuropathies throughout the body (Buntragulpoontawee et al., 2021).

A newer review also describes hydrodissection as a promising treatment for mild-to-moderate entrapment neuropathies while emphasizing the need for stronger evidence involving nerves outside the carpal tunnel.

This is why accurate diagnosis and image guidance matter.

Where Does Regenerative Medicine Fit?

Regenerative medicine is an exciting area, but it is important not to promise more than current evidence supports.

PRP has been studied as an injectate for some peripheral nerve entrapments, particularly carpal tunnel syndrome. Research into biological treatments for peripheral nerve healing continues.

Micro-fragmented adipose tissue, or MFAT, contains adipose tissue with cells and signaling molecules that are being studied for tissue repair. Much of the current clinical research involves joints, cartilage, wounds, and other musculoskeletal problems rather than routine treatment of sports neuropathy (Fu & Wang, 2025).

Therefore, MFAT should not be described as a proven standard treatment for athletic nerve injuries. Its possible role may become clearer as regenerative medicine research develops.

This distinction matters. A regenerative procedure cannot correct a tight ski boot, unstable ankle, poor throwing mechanics, compressive scar, or bone structure pressing against a nerve. Mechanical causes still require mechanical solutions.

Connecting Mechanical and Biological Recovery

A comprehensive approach can therefore be thought of in layers:

1. Identify the nerve involved.
2. Identify what is irritating it.
3. Reduce compression or repetitive stress.
4. Correct movement and joint mechanics.
5. Restore strength and nerve mobility.
6. Address metabolic or nutritional factors when relevant.
7. Consider advanced procedures only when clinically appropriate.
8. Progress gradually back into sport.

This helps connect structural recovery with the biological conditions needed for tissue healing.

Dr. Jimenez’s Integrative Clinical Approach in El Paso

The published clinical materials of Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, emphasize looking beyond the painful area and examining biomechanics, neurological function, rehabilitation, nutrition, and metabolic health together.

His Injury Medical Clinic PA model in El Paso combines:

• Integrative chiropractic care
• Sports injury management
• Functional medicine
• Rehabilitation
• Personal injury care
• Medical assessment
• Diagnostic coordination
• Nutrition and lifestyle support
• Selected advanced treatment options

Dr. Jimenez’s clinical materials describe an approach that combines correcting biomechanics with a broader medical and functional assessment, rather than treating each problem in isolation.

Medical Oversight With Dr. Maria Guadalupe Cardenas, MD

This multidisciplinary model also includes Maria Guadalupe Cardenas, MD.

The American Medical Association lists Dr. Cardenas as an internal medicine physician practicing in El Paso. Current Injury Medical Clinic materials identify her as board-certified in internal medicine and as the practice’s medical director and collaborative physician, listing NPI #1164426749 and Texas MD License #J2933. Clinic materials report that she has more than 40 years of experience in internal medicine.

Within this model, Dr. Cardenas provides medical direction, while Dr. Jimenez contributes chiropractic, nurse practitioner, functional medicine, neuromusculoskeletal, and rehabilitation expertise.

This creates a broader system for evaluating athletes who may have several problems at once. A nerve complaint, for example, could involve mechanical compression but may also be influenced by inflammation, previous trauma, metabolic disease, nutritional deficiencies, medication issues, or another medical condition.

The team can therefore coordinate:

• Chiropractic care
• Medical oversight
• Functional medicine
• Rehabilitation
• Diagnostic testing
• Personal injury services
• Referrals when specialist care is required
• Advanced procedures when medically appropriate

The Bottom Line

Neuropathies absolutely can occur in sports.

Some happen suddenly after impact, stretching, fracture, or dislocation. Others develop slowly from hundreds or thousands of repeated movements.

Successful treatment starts by determining which nerve is affected and why.

For many athletes, the best plan isn’t a single treatment. It is a coordinated process that combines diagnosis, reducing nerve stress, rehabilitation, biomechanical correction, and appropriate medical care.

Chiropractic care can help address movement and mechanical contributors. Rehabilitation rebuilds stability and function. Medical oversight helps identify conditions that may require medication, imaging, diagnostic testing, injections, or specialist referral. Laser and shockwave therapies may serve as selected adjuncts. Ultrasound-guided hydrodissection and certain regenerative approaches are expanding areas of treatment, but they should be used based on the diagnosis and the strength of available evidence.

This combined strategy connects mechanical recovery with biological healing while keeping the athlete’s long-term function and safe return to activity at the center of care.

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References

Buntragulpoontawee, M., Chang, K.-V., Vitoonpong, T., Pornjaksawan, S., Kitisak, K., Saokaew, S., & Kanchanasurakit, S. (2021). The effectiveness and safety of commonly used injectates for ultrasound-guided hydrodissection treatment of peripheral nerve entrapment syndromes: A systematic review. Frontiers in Pharmacology, 11, 621150. https://doi.org/10.3389/fphar.2020.621150

Fu, H., & Wang, C. (2025). Micro-fragmented adipose tissue—An innovative therapeutic approach: A narrative review. Medicine, 104(9), e41724. https://doi.org/10.1097/MD.0000000000041724

Hirasawa, Y., & Sakakida, K. (1983). Sports and peripheral nerve injury. The American Journal of Sports Medicine, 11(6), 420–426. https://doi.org/10.1177/036354658301100607

Li, X., Yang, L., Li, S., Yang, J., & Meng, D. (2024). Effect of extracorporeal shock wave therapy on nerve conduction: A systematic review and meta-analysis. Frontiers in Neurology, 15, 1493692. https://doi.org/10.3389/fneur.2024.1493692

Mitchell, C. H., Brushart, T. M., Ahlawat, S., Belzberg, A. J., Carrino, J. A., & Fayad, L. M. (2014). MRI of sports-related peripheral nerve injuries. American Journal of Roentgenology, 203(5), 1075–1084. https://doi.org/10.2214/AJR.13.12183

Radić, B., Radić, P., & Duraković, D. (2018). Peripheral nerve injury in sports. Acta Clinica Croatica, 57(3), 561–569. https://doi.org/10.20471/acc.2018.57.03.20

Senk, A. M., & Carlson, A. (2026). Ankle and foot neuropathies and entrapments. PM&R KnowledgeNow, American Academy of Physical Medicine and Rehabilitation.

Stokes, D. C., Toole, K., & Cushman, D. M. (2025). Upper extremity neuropathies in athletes. Current Sports Medicine Reports, 24(11), 356–365. https://doi.org/10.1249/JSR.0000000000001297

Mallac, C. (n.d.). Uncommon injuries: Sural nerve neuropathy. Sports Injury Bulletin.

Jimenez, A. (2026). How regenerative medicine and chiropractic care work together. LinkedIn.

Jimenez, A. (2026). El Paso chiropractor Dr. Alex Jimenez: Integrative chiropractic and injury care. DrAlexJimenez.com.

American Medical Association. (n.d.). María Guadalupe Cárdenas, MD—Internal medicine, El Paso, Texas. AMA Find a Doctor.