Sports Neuropathy: Integrative Chiropractic and Nerve Care Skip to main content

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Chiropractic Podcast

Sports Neuropathy: Integrative Chiropractic and Nerve Care

Abstract

Can athletes develop neuropathy? Yes. Sports neuropathies are nerve problems caused by compression, stretching, repeated impact, poor biomechanics, or direct trauma during exercise and competition. Athletes may notice burning pain, numbness, tingling, weakness, loss of grip, foot drop, or changes in coordination.

Sports neuropathy can be difficult to recognize because nerve symptoms may resemble muscle strains, tendon injuries, joint problems, or spinal conditions. Research shows that careful examination, nerve testing, ultrasound, and MRI may be needed to locate the source of the problem.

Treatment usually starts conservatively. Depending on the injury, care may include rest, activity changes, rehabilitation, biomechanical correction, integrative chiropractic care, nerve-mobility exercises, and medical management. Some patients may also be candidates for ultrasound-guided injections, laser therapy, shockwave therapy, or emerging regenerative treatments. Select these advanced treatments carefully because the level of scientific evidence varies by therapy.

At Injury Medical Clinic PA in El Paso, Texas, Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, integrates chiropractic care, functional medicine, rehabilitation, and injury care with medical oversight from Dr. Maria Guadalupe Cardenas, MD, an internal medicine physician.


Are There Neuropathies in Sports?

Yes. Peripheral nerve injuries can occur during sports training, exercise, and competition.

A peripheral nerve carries signals between the brain, spinal cord, muscles, and skin. When that nerve is compressed, stretched, irritated, or injured, communication may become less efficient.

Sports-related peripheral nerve injuries often develop from:

  • Repetitive microtrauma

  • Direct blows or collisions

  • Stretching of a nerve

  • Compression from muscles or equipment

  • Joint injuries

  • Fractures

  • Poor movement mechanics

  • Repeated positions used in a specific sport

Mitchell et al. (2014) reported that sports-related nerve injuries are sometimes overlooked because their symptoms can resemble more common muscle, tendon, bone, and joint injuries. Chronic repetitive stress appears to be more common than major acute nerve injury in athletes.

Radić et al. (2018) similarly explained that sports nerve injuries may result from pressure, stretching, fractures, or repetitive overuse. Early identification matters because the type and severity of nerve damage can affect recovery.

What Does Sports Neuropathy Feel Like?

Neuropathy does not always feel like normal muscle soreness.

Athletes may report:

  • Burning pain

  • Tingling or "pins and needles"

  • Numbness

  • Electric or shooting pain

  • Weakness

  • Muscle fatigue

  • Loss of grip strength

  • Foot drop

  • Reduced coordination

  • Changes in balance

  • Pain that increases during a specific athletic movement

Some symptoms appear only during activity.

For example, some runners may develop nerve symptoms while running but have few symptoms at rest or while walking. Foot and ankle entrapment neuropathies can also become worse during physical activity and improve with rest (Senk & Carlson, 2026).

Which Nerves Can Athletes Injure?

The nerve involved often depends on the sport and movement pattern.

Throwing Athletes

Baseball, softball, tennis, and other throwing sports can place stress on nerves around the shoulder and elbow.

Possible problems include:

  • Ulnar nerve irritation

  • Suprascapular neuropathy

  • Axillary nerve injury

  • Radial nerve problems

A recent review by Stokes et al. (2025) describes upper-extremity neuropathies as an important and sometimes overlooked cause of pain and impaired performance in athletes.

Cyclists

Cyclists may experience:

  • Ulnar nerve compression at the hand

  • Median nerve compression

  • Pudendal nerve irritation

Handlebar pressure, wrist position, prolonged sitting, and bike setup can all contribute to nerve stress (Mitchell et al., 2014).

Runners

Running may contribute to:

  • Tibial nerve compression

  • Medial plantar nerve entrapment, sometimes called "jogger's foot"

  • Sural nerve irritation

  • Morton-type interdigital nerve problems

  • Common peroneal nerve irritation

The American Academy of Physical Medicine and Rehabilitation notes that repetitive sports activity, footwear, gait problems, ankle injuries, and abnormal mechanics may all contribute to foot and ankle nerve entrapment.

Contact-Sport Athletes

Football, wrestling, hockey, martial arts, and similar sports may produce nerve injuries through direct impact or sudden stretching.

One familiar example is a "stinger" or "burner," in which forceful movement of the neck and shoulder temporarily injures or irritates the brachial plexus.

More severe injuries require prompt evaluation because a completely disrupted nerve cannot simply be treated like a muscle strain.


How Is Sports Neuropathy Diagnosed?

Finding the actual source is one of the most important parts of treatment.

A clinician may evaluate:

  • Strength

  • Reflexes

  • Sensation

  • Joint movement

  • Spinal function

  • Gait

  • Balance

  • Muscle control

  • Nerve tension

  • Sports technique

Tests may include:

  • MRI

  • Magnetic resonance neurography

  • Diagnostic ultrasound

  • Electromyography (EMG)

  • Nerve-conduction studies

  • X-rays when bone or alignment problems are suspected

MRI may show nerve swelling, compression, changes in nerve structure, or secondary muscle changes from loss of normal nerve signals (Mitchell et al., 2014).

High-resolution ultrasound can also help physicians examine a nerve while the patient moves. This can be useful when compression occurs only in certain positions.


Integrative Chiropractic Care for Sports Neuropathy

Chiropractic care does not replace neurological testing or surgical care when a nerve has been seriously damaged.

Its role is different.

Integrative chiropractic care can focus on biomechanical factors surrounding the irritated nerve.

This may include:

  • Improving joint mobility

  • Addressing abnormal spinal or extremity mechanics

  • Evaluating posture

  • Improving hip, knee, ankle, shoulder, or elbow movement

  • Correcting movement patterns

  • Soft-tissue treatment

  • Progressive strengthening

  • Balance and coordination exercises

  • Neurodynamic or nerve-mobility exercises

  • Return-to-sport rehabilitation

For example, an athlete with tibial nerve irritation may also have excessive pronation, ankle instability, or an altered running pattern. Correcting those contributing mechanical problems may reduce repeated stress around the nerve.

PM&R guidance specifically recommends examining gait and alignment and using rehabilitation to address ankle instability and muscular weakness when appropriate.

In Dr. Alexander Jimenez's clinical framework, nerve symptoms are examined within the larger movement system. His published professional materials emphasize mobility, posture, functional rehabilitation, sports-injury care, chiropractic treatment, and investigation of metabolic or systemic factors that may complicate nerve symptoms.

The goal is not simply to "adjust a nerve." It is to identify mechanical forces that may continue irritating the nerve and then build a safer environment for recovery.


Laser Therapy and Sports Neuropathy

Photobiomodulation, sometimes called low-level laser therapy, is another treatment being studied for peripheral nerve problems.

A review by Fallah et al. (2017) examined clinical studies involving peripheral sensory neuropathy. Several studies reported improvements in sensory function, but treatment methods varied widely. The authors concluded that more research was needed before a single treatment protocol could be recommended.

For this reason, laser therapy may be considered an adjunct, rather than a proven replacement for diagnosis, rehabilitation, or treatment of the underlying compression.

In an integrative sports program, laser may be combined with movement correction and rehabilitation when clinically appropriate.


What About Shockwave Therapy?

Extracorporeal shockwave therapy is widely used for certain tendon and musculoskeletal conditions. Researchers are also studying whether specific shockwave approaches affect peripheral nerves.

Laboratory and clinical research has produced mixed findings. Some studies suggest possible effects on nerve regeneration and recovery, while other studies raise questions about how shockwaves affect sensory nerves. A recent systematic review concluded that the relationship between shockwave treatment and nerve conduction is still being studied.

Therefore, shockwave therapy should not automatically be applied directly over every painful nerve.

It may be more appropriate when treating an associated tendon, fascia, scar, or musculoskeletal problem, depending on the diagnosis.


Targeted Injections for Entrapped Nerves

Some nerve entrapments do not respond fully to rehabilitation alone.

Ultrasound-guided injections may then be considered.

Hydrodissection

Nerve hydrodissection involves placing fluid around an entrapped nerve under ultrasound guidance. The goal is to gently separate the nerve from surrounding tissues that may be restricting its normal movement.

Different solutions have been studied, including:

  • Saline

  • Local anesthetics

  • Corticosteroids

  • Dextrose

  • Platelet-rich plasma

A systematic review found encouraging results from ultrasound-guided hydrodissection, especially for carpal tunnel syndrome, although evidence is much more limited for many other nerve entrapments (Buntragulpoontawee et al., 2021).

The American Academy of Physical Medicine and Rehabilitation also notes that ultrasound-guided local anesthetic and corticosteroid injections may sometimes have both diagnostic and therapeutic value in foot and ankle entrapment neuropathies.


Can Regenerative Medicine Help an Injured Nerve?

This is one of the most interesting areas of current research, but it is important to separate promising science from established treatment.

Platelet-Rich Plasma

Platelet-rich plasma, or PRP, contains concentrated platelets and biological signaling molecules.

Research into PRP for peripheral nerve injury is growing.

A small 2025 randomized trial involving 30 people with incomplete sciatic nerve injuries found that ultrasound-guided PRP combined with rehabilitation improved several nerve function measurements. The authors described PRP as potentially helpful for early repair but did not establish it as a universal treatment for peripheral nerve injury (Yang et al., 2025).

This research is promising, but larger trials are still needed.

Microfragmented Adipose Tissue

Microfragmented adipose tissue, or MFAT, is prepared from a patient's own fat tissue and is being investigated in regenerative medicine.

A 2025 narrative review described its potential regenerative, immunomodulatory, and anti-inflammatory properties. Research is exploring applications involving joints, soft tissues, vascular repair, and neural regeneration (Fu & Wang, 2025).

However, MFAT should not currently be presented as a proven treatment for routine sports neuropathy. Its role in peripheral nerve healing remains emerging and depends heavily on the condition being treated, regulations, patient selection, and available evidence.

Discuss regenerative procedures individually with appropriately licensed healthcare professionals.


Why Combine Structural, Medical, and Biological Care?

Sports neuropathy is rarely just about pain.

The athlete may have:

  • A compressed nerve

  • Joint dysfunction

  • Swelling

  • Scar tissue

  • Weakness

  • Poor movement mechanics

  • Nutritional deficiencies

  • Diabetes or metabolic problems

  • Previous injuries

  • Tendon or ligament damage at the same time

This explains the value of a multi-layered approach.

Chiropractic and rehabilitation can focus on biomechanics and movement.

Medical evaluation can identify diseases, medication effects, metabolic problems, or serious nerve injuries.

Diagnostic imaging and electrodiagnostic testing can help determine exactly where the nerve is injured.

Targeted injections may help selected entrapment conditions.

Advanced modalities may be added when evidence, diagnosis, and patient needs support them.

Regenerative strategies may have a role in carefully selected cases, but several applications remain emerging rather than established standards of care.


A Multidisciplinary Model in El Paso, Texas

At Injury Medical Clinic PA in El Paso, Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, works within a multidisciplinary model combining chiropractic care, functional medicine, personal injury care, rehabilitation, and related services.

Dr. Jimenez's professional profile emphasizes sports injuries, neuropathy, biomechanics, functional rehabilitation, and integrative approaches to musculoskeletal health.

The practice also works with Dr. Maria Guadalupe Cardenas, MD, an internal medicine physician in El Paso. Public NPI-derived records identify Dr. Cardenas as an internal medicine physician who graduated from medical school in 1982, giving her more than four decades of medical experience. These records identify NPI #1164426748 and Texas medical license J2933. Clinic materials identify her as board-certified in internal medicine and serving as medical director and collaborative physician.

In this type of coordinated model:

  • Dr. Jimenez focuses on neuromusculoskeletal assessment, chiropractic care, movement mechanics, functional medicine, and rehabilitation.

  • Dr. Cardenas provides internal medicine experience and medical oversight.

  • Rehabilitation addresses strength, stability, balance, coordination, and safe return to activity.

  • Functional medicine may investigate nutrition and metabolic factors that can influence nerve health.

  • Personal injury services help document and manage traumatic injuries.

  • Advanced procedures can be considered when clinically appropriate and within each provider's scope of practice.

The benefit of multidisciplinary care is not that every athlete receives every available treatment. The benefit is having different clinical tools available so treatment can match the diagnosis.


When Should an Athlete Seek Medical Attention?

Numbness or tingling should not simply be "played through."

Prompt evaluation is especially important when an athlete develops:

  • Progressive weakness

  • Foot drop

  • Loss of grip

  • Major loss of sensation

  • Severe burning pain

  • Loss of balance

  • Symptoms following a fracture or dislocation

  • Symptoms that continue after rest

  • Muscle wasting

  • Loss of bladder or bowel control

  • Sudden widespread neurological symptoms

Early diagnosis can sometimes prevent temporary nerve irritation from progressing into more serious dysfunction.


The Bottom Line

Yes, neuropathies occur in sports.

They can result from repetitive microtrauma, compression, stretching, direct impact, fractures, joint injuries, equipment, or abnormal movement mechanics.

Successful care starts by identifying exactly which nerve is involved and why it is being irritated.

For many athletes, treatment begins with activity modification, rehabilitation, correction of movement problems, and appropriate medical management. Integrative chiropractic care can complement this process by addressing joint mechanics, mobility, posture, gait, and neuromuscular function.

Laser therapy, shockwave therapy, ultrasound-guided injections, PRP, and other regenerative approaches may add another layer of treatment in carefully selected cases. However, the evidence varies considerably among these therapies, and some regenerative approaches remain investigational for peripheral nerve healing.

The strongest strategy, therefore, is not simply adding more treatments. It is matching the right treatment to the right nerve problem while addressing structural, neurological, medical, and functional factors together.


References

Buntragulpoontawee, M., et al. (2021). The effectiveness and safety of commonly used injectates for ultrasound-guided hydrodissection treatment of peripheral nerve entrapment syndromes. Frontiers in Pharmacology.

Fallah, A., Mirzaei, A., Gutknecht, N., & Demneh, A. S. (2017). Clinical effectiveness of low-level laser treatment on peripheral somatosensory neuropathy. Lasers in Medical Science, 32(3), 721–728.

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

Hirasawa, Y., & Sakakida, K. (1983). Sports and peripheral nerve injury. American Journal of Sports Medicine, 11(6), 420–426.

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.

Radić, B., Radić, P., & Duraković, D. (2018). Peripheral nerve injury in sports. Acta Clinica Croatica, 57(3), 561–569.

Senk, A. M., & Carlson, A. (2026). Ankle and foot neuropathies and entrapments. PM&R KnowledgeNow.

Stokes, D. C., Toole, K., & Cushman, D. M. (2025). Upper extremity neuropathies in athletes. Current Sports Medicine Reports, 24(11), 356–365.

Yang, C., Wang, C., Wang, C., Yang, G., & Wu, W. (2025). The effectiveness of platelet-rich plasma in the treatment of sciatic nerve injury: A single-blind randomized comparative trial. Neural Plasticity, 2025, 7540054.

Jimenez, A. Dr. Alex Jimenez—Clinical and integrative health resources.

Jimenez, A. Dr. Alexander Jimenez—Professional profile. LinkedIn.

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The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, and physical medicine, as well as wellness, sensitive health issues, and functional medicine articles, topics, and discussions. We provide and facilitate clinical collaboration with specialists across disciplines. Each specialist is governed by their professional scope of practice and the jurisdiction in which they are licensed. We utilize functional health and wellness protocols to treat and support care for musculoskeletal injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters and issues that directly or indirectly support our clinical scope of practice. Our office has made a reasonable effort to provide supportive citations and identify relevant research studies for our posts. We provide copies of supporting research studies upon request to regulatory boards and the public.

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Blessings

Dr. Alex Jimenez, DC, MSACP, APRN, FNP-BC*, CCST, IFMCP, CFMP, ATN

email: coach@elpasofunctionalmedicine.com

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Professional Scope of Practice * The information on this blog site is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Blog Information & Scope Discussions Welcome to El Paso's Premier Wellness and Injury Care Clinic & wellness blog, where Dr. Alex Jimenez, DC, FNP-C, a board-certified Family Practice Nurse Practitioner (FNP-BC) and Chiropractor (DC), presents insights on how our team is dedicated to holistic healing and personalized care. Our practice aligns with evidence-based treatment protocols inspired by integrative medicine principles, similar to those found on dralexjimenez.com, focusing on restoring health naturally for patients of all ages. Our areas of chiropractic practice include Wellness and nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, severe sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. Our information scope is limited to Chiropractic, musculoskeletal, physical medicine, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, please feel free to ask Dr. Alex Jimenez, DC, APRN, FNP-BC, or contact us at 915-850-0900. We are here to help you and your family. Blessings Dr. Alex Jimenez DC, MSACP, APRN, FNP-BC*, CCST, IFMCP*, CFMP*, ATN* email: coach@elpasofunctionalmedicine.com Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico* Texas DC License # TX5807 New Mexico DC License # NM-DC2182 Licensed as a Registered Nurse (RN*) in Texas & Multistate  Texas RN License # 1191402  Compact Status: Multi-State License: Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP*, IFMCP*, ATN*, CCST