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Home » IDEA Answers » Peroneal nerve dysfunction?
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Question asked by Jocelyn Martin 493 days ago

Peroneal nerve dysfunction?

Personal TrainerDisabilities and DiseasesSpecial Populations

I have a client who was recently diagnosed with peroneal nerve dysfunction. It is not severe enough that she has foot drop, but she does have numbness to the outside of her knee and difficulty getting up from the floor. Her doctor did not recommend physical therapy or give her any exercise suggestions for treatment. She did suggest not to hyper extend or flex the knee as well as not bending the knee beyond 90degrees.

Has anyone had a client who has had peroneal nerve dysfunction? What exercises did you do or not do to help the client with this condition?

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Answered by Lisa Roper 435 days ago
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Try stretching the peroneal nerve area by lying on your back, and then leg in the air, sickle the foot - now take the sickled foot across the mid-line of the body to increase the stretch (add a strap of some sort over the foot if flexability is an issue). Don't over do this. I have nerve damage to that area from a low back injury so I do these stretches daily. Simple ankle rotations along with the above stretch is also helpful. Bringing bloodflow to an area to heal and nourish is really important - these moves will accomplish that.
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Answered by Joanne Duncan-Carnesciali 493 days ago
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What is the cause of the peroneal nerve dysfunction?

Too, before anyone can determine which exercises are appropriate for the client, it is important to determine what exercises tests are you going to use as a baseline in order to choose appropriate exercises.

One of my clients who is 88-years old has peroneal nerve dysfunction as a consequence of Parkinsons. I wish I could give you an answer but it is a little difficult as a consequence of not having objective data.
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She says it was brought on by her pregnancy. Her ob/gyn seems to think it will correct itself through time after her pregnancy (she delivered 9 weeks ago). Her neurologist thinks it will not.

My difficulty is that most exercises for treatment are to increase strength to continue day to day living. She is already having trouble getting down on the floor and getting back up. With a baby at home and a toddler, these are definitely things she needs to be able to do. However, her doctor cautioned against movements beyond 90degrees of the knee.

As for baseline exercise tests, I had her perform a wall sit, not coming fully down but only 3/4 of the way and a horse stance, same, not coming parallel to the floor. All of her tests were normal. She had no loss of strength. This was also confirmed by her neurologist which is why she did not refer her to physical therapy.

My thoughts are to have her start with daily living motions. Getting up and down off the floor, partial squats, partial lunges, isometric at first then building to adding motion. I'm not quite sure yet. I'm thinking out loud and trying to research all I can on the subject. Any help you can offer in dealing with this dysfunction would be appreciated.
Comment by Jocelyn Martin 493 days ago
I would also include strength training for the lower leg for that is where the weakness is. She has to weight bear first before she gets up off the floor, do partial squats partial lunges, etc. The base of support must be stable first.

Hope this helps.
Comment by Joanne Duncan-Carnesciali 492 days ago
Perhaps including inversion, eversion, flextion and extension of the ankle using therabands wich will help keep the area strong. Its most important to maintain full ROM in every joint in the body as long as it pain free...therefore....if it doesnt hurt...KEEP AT IT AND MORE!

I would try to strengthen her lower back and hip joints using weighted leg raises in supine (this keeps the knee out of the picture for now). Perform glute, hamstring, piriformis, IT Band and psoas stretches to help ease the path of the sciatic neve to where it splits . It could be that the nerve is restricted anywhere in the upper leg as well.

Just my spin on the issue
Good luck

PS...a massage to help loosen the low back and especially hamtring area would help her feel a lot better and motivated too
Comment by Yasmin Hassim 492 days ago
 
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Answered by Shawn Fears 489 days ago
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I would recommend finding a second opinion that is more helpful.
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Ha Shawn! That was my first reaction. Unfortunately, both her and I are stationed at a military base overseas and only have access to one neurologist. Sometimes you have to work with what you've got!

I've been working with some of the physical therapists here to come up with an approach that will help her regain her mobility and meet her goals.
Comment by Jocelyn Martin 489 days ago
 
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Answered by Dorothy Chaveriat 443 days ago
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Jocelyn, Without additional history, it sounds like an irritated peroneal nerve. That could have arisen out of anything along the nerve, from its root to the top of the toes. Most of the time it is caused by faulty movement, potentially even unnoticeable small abhorrent movement, or non-movement. Strengthening muscles around an irritated nerve is pretty much futile. Please know that current pain research states that the site of pain is typically not the site where the problem is. There are techniques to approach the nerve and get it to calm down - actively. An active approach is far superior to a passive approach in this sort of case. I am a Z-Health Practitioner, but in Chicago. I believe there is a certified Z-Health trainer in Japan. There is a directory on the Z-Health website: zhealth.net. I would highly recommend contacting that person. If you have any questions at all, please feel free to contact me through the email address on my profile.
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