Sports Neuropathy Treatment: An Integrated Approach in El Paso

Abstract

Athletes depend on healthy nerves for strength, balance, coordination, speed, and precise movement. However, sports can sometimes place nerves under enough pressure, stretch, or repeated stress to cause a neuropathy. Sports neuropathies may develop after a sudden injury or slowly through repetitive microtrauma.

Symptoms can include burning, tingling, numbness, weakness, electric-like pain, poor balance, or reduced athletic performance. Because these symptoms can look like muscle, tendon, joint, or spinal injuries, sports-related nerve problems are sometimes missed.

At ChiroMed – Integrated Medicine in El Paso, Texas, the goal is to look beyond the painful nerve alone. An integrated plan may include chiropractic care, rehabilitation, medical oversight, functional medicine, advanced physical therapies, and selected regenerative or injection-based treatments when medically appropriate. The purpose is to address the mechanical environment around the nerve while also considering the athlete’s overall health and tissue recovery.

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Can Athletes Really Develop Neuropathy?

Yes. Neuropathies can occur in sports.

Peripheral nerves connect the brain and spinal cord with the muscles, skin, and other tissues. These nerves carry signals that allow an athlete to feel, move, react, and maintain coordination.

A nerve can become irritated or injured when it experiences:

• Repeated compression
• Repetitive microtrauma
• Sudden stretching
• Direct impact
• Joint dislocation
• Bone fracture
• Swelling around the nerve
• Poor movement mechanics
• Tight muscles or connective tissues
• Pressure from athletic equipment or footwear

Mitchell et al. (2014) explain that sports-related peripheral neuropathies can result from serious acute injuries, but chronic repetitive stress is often more common. These nerve injuries may also be overlooked because their symptoms can resemble more common sports injuries involving muscles, tendons, joints, and bones.

Radić et al. (2018) similarly reported that sports nerve injuries can occur from pressure, stretching, fractures, and repetitive overuse.

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Why Sports Neuropathy Can Be Easy to Miss

A nerve injury does not always cause obvious numbness.

Sometimes the first complaint is simply pain, weakness, tightness, or poor performance.

An athlete may believe the problem is a strained muscle when the real source is an irritated nerve.

Possible symptoms include:

• Burning pain
• Pins-and-needles sensations
• Tingling
• Numbness
• Shooting or electric pain
• Muscle weakness
• Reduced grip
• Foot weakness
• Problems lifting the foot
• Loss of coordination
• Reduced balance
• Pain that appears only during exercise

Upper-extremity neuropathies can be especially difficult to recognize because symptoms may be subtle. A recent sports medicine review notes that numbness, tingling, weakness, and other neurological findings can occur, while EMG, nerve-conduction studies, ultrasound, and MRI may help confirm the diagnosis (Stokes et al., 2025).

The lesson for athletes is simple:

Persistent nerve-like symptoms deserve a closer look.

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What Sports Are Associated With Nerve Problems?

The nerve at risk often depends on how the athlete moves.

Running

Runners may develop nerve irritation around the lower leg, ankle, or foot.

Examples include:

• Tibial nerve compression
• Tarsal tunnel syndrome
• Sural nerve irritation
• Common fibular or peroneal nerve problems
• Medial plantar nerve entrapment
• Interdigital nerve irritation

Foot and ankle neuropathies are often seen in running athletes. Repetitive microtrauma, abnormal gait, footwear, previous injuries, and mechanical stress can contribute to nerve compression (Senk & Carlson, 2026).

The sural nerve is one good example. Sural nerve irritation may produce pain, burning, or tingling along the outside of the ankle, heel, and foot. It can sometimes be confused with an Achilles tendon problem.

Baseball and Throwing Sports

Throwing places repeated forces across the shoulder and elbow.

Nerves that may become irritated include:

• Ulnar nerve
• Suprascapular nerve
• Axillary nerve
• Radial nerve

The repetitive throwing motion can create traction or compression that gradually affects nerve function.

Cycling

Cyclists may experience nerve compression from long periods in the same position.

Possible problems include:

• Ulnar nerve compression at the hand
• Median nerve compression
• Pudendal nerve irritation

Bike fit, wrist position, saddle position, and training duration can all influence mechanical stress.

Football, Wrestling, Hockey, and Contact Sports

Contact athletes can develop nerve problems from:

• Direct blows
• Joint dislocations
• Neck and shoulder trauma
• Knee injuries
• Stretching of the brachial plexus

Hirasawa and Sakakida (1983) found that continuous compression and repeated nerve trauma were common causes of sports-related peripheral nerve injury.

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Diagnosis Comes Before Treatment

At ChiroMed, an integrated treatment plan should begin by determining what is actually causing the symptoms.

Not all tingling is neuropathy.

Nerve symptoms can also come from:

• Herniated spinal discs
• Sciatica
• Cervical radiculopathy
• Carpal tunnel syndrome
• Diabetes
• Thyroid disease
• Vitamin deficiencies
• Previous fractures
• Scar tissue
• Tendon swelling
• Joint instability

An examination may include:

• Strength testing
• Reflex testing
• Sensory testing
• Range-of-motion testing
• Orthopedic examination
• Neurological examination
• Gait analysis
• Posture assessment
• Functional movement testing

When appropriate, additional testing may include:

• MRI
• Diagnostic ultrasound
• Electromyography, or EMG
• Nerve-conduction studies
• X-rays

MRI can be especially helpful because it may show nerve abnormalities, compression, swelling, and changes within muscles supplied by an injured nerve (Mitchell et al., 2014).

Early diagnosis also matters because severe nerve injuries may need specialty or surgical evaluation rather than conservative care alone.

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Where Integrative Chiropractic Care Fits

Chiropractic care does not directly “regrow” an injured peripheral nerve.

Its role is to improve the mechanical environment surrounding the nerve.

Imagine an athlete has an irritated tibial nerve at the ankle. The nerve problem may occur along with:

• Restricted ankle movement
• Excessive foot pronation
• Weak hip muscles
• Poor running mechanics
• Tight calf tissues
• Previous ankle injuries

Only treating the painful nerve may leave these mechanical problems unchanged.

At ChiroMed – Integrated Medicine, chiropractic and rehabilitative care can address these contributing factors. ChiroMed describes its model as combining chiropractic treatment, rehabilitation, nurse practitioner services, nutrition, and other healthcare services in a patient-centered, integrated approach.

Depending on the condition, care may include:

• Chiropractic adjustments
• Joint mobilization
• Soft-tissue techniques
• Mobility exercises
• Posture correction
• Gait evaluation
• Core stabilization
• Balance training
• Strengthening
• Nerve-gliding exercises
• Sport-specific rehabilitation

The purpose is to help the athlete move more efficiently and reduce repeated stress on injured tissues.

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Dr. Alex Jimenez’s ChiroMed Clinical Approach

At ChiroMed, Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, approaches sports injuries from both mechanical and whole-health viewpoints.

His clinical observations focus on an important idea:

Where the athlete hurts may not be the only area contributing to the problem.

For example, recurring foot nerve symptoms may be influenced by ankle mobility, knee mechanics, hip control, spinal function, running technique, or metabolic health.

His integrated assessment may therefore consider:

• Spinal mechanics
• Joint motion
• Muscle balance
• Gait
• Posture
• Strength
• Neurological function
• Nutrition
• Recovery
• Sleep
• Metabolic health
• Previous injuries

This approach matches ChiroMed’s broader goal of addressing the factors contributing to a patient’s problem instead of concentrating only on symptoms.

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Medical Oversight With Dr. Maria Guadalupe Cardenas

Complex nerve symptoms may involve more than biomechanics.

That is why medical oversight can become important.

Dr. Maria Guadalupe Cardenas, MD, is a board-certified internal medicine physician with more than 40 years of medical experience. Public provider information identifies her as NPI #1164426749 and Texas medical license #J2933. ChiroMed materials describe Dr. Cardenas as Medical Director and Collaborative Physician for Injury Medical Clinic PA in El Paso.

Dr. Cardenas works alongside Dr. Jimenez within a multidisciplinary model.

This collaboration allows the team to consider issues such as:

• Diabetes
• Thyroid disease
• Circulation problems
• Medication effects
• Nutritional deficiencies
• Inflammatory disorders
• Kidney or liver concerns
• Other medical conditions affecting nerve health

The medical-chiropractic model can bring together:

• Chiropractic care
• Internal medicine oversight
• Functional medicine
• Personal injury care
• Rehabilitation
• Nutritional support
• Advanced treatment options
• Referral coordination

This does not mean every patient needs every service. Treatment should be based on the patient’s diagnosis and individual needs.

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Can Laser Therapy Support Neuropathy Care?

Photobiomodulation, often called therapeutic laser therapy, has been studied for several pain and nerve conditions.

Researchers are interested in whether specific wavelengths of light may influence inflammation, circulation, mitochondrial activity, and cellular signaling.

However, laser therapy should be viewed as an adjunct treatment, not a replacement for diagnosing the cause of nerve compression.

At ChiroMed, a more complete strategy may combine an advanced modality with:

• Chiropractic care
• Movement correction
• Rehabilitation
• Strengthening
• Medical evaluation

The goal is not simply to apply a laser where something hurts. The larger goal is to determine why the nerve is irritated and address those contributing factors.

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What About Shockwave Therapy?

Shockwave therapy sends acoustic energy into tissues.

It has stronger established use for several tendon and musculoskeletal problems than it does for directly treating peripheral neuropathy.

This distinction matters.

An athlete with nerve symptoms may also have:

• Tendinopathy
• Scar tissue
• Fascia restrictions
• Chronic muscle problems
• Joint dysfunction

In selected patients, shockwave treatment may target an associated musculoskeletal problem as part of an overall rehabilitation program.

It should not be presented as a universal treatment that regenerates damaged nerves.

At ChiroMed, advanced treatments are best used as part of a larger care strategy rather than as stand-alone procedures. ChiroMed’s current integrated injury-care materials similarly describe shockwave and other technologies as tools that work alongside diagnosis, rehabilitation, chiropractic care, and medical oversight.

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Targeted Injections and Nerve Entrapment

Some patients continue to experience symptoms even after activity changes and rehabilitation.

In selected cases, ultrasound-guided procedures may be considered.

One example is nerve hydrodissection.

During hydrodissection, fluid is carefully placed around a compressed peripheral nerve under ultrasound guidance. The goal is to separate the nerve from surrounding tissue that may limit movement or create pressure.

Injection options used in different clinical settings and studies have included:

• Saline
• Local anesthetic
• Corticosteroid
• Dextrose
• Platelet-based preparations

These procedures are not appropriate for every neuropathy.

The exact diagnosis, location, severity, medical history, and available research should guide treatment.

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Regenerative Medicine and Nerve Recovery

Regenerative medicine is another area receiving growing attention.

Possible approaches include:

• Platelet-rich plasma, or PRP
• Platelet-based fibrin preparations
• Microfragmented adipose tissue, or MFAT

These therapies are designed to provide biological signals or supportive tissue to an injured area.

However, an important distinction must be made:

Regenerative medicine for peripheral nerve repair remains an evolving field.

MFAT, for example, contains adipose tissue with cells and signaling factors associated with tissue repair. A 2025 narrative review describes potential regenerative and anti-inflammatory applications, including interest in neural regeneration, but the authors also stress that larger clinical trials are needed to establish long-term safety and effectiveness (Fu & Wang, 2025).

Therefore, regenerative therapy should not be described as a guaranteed way to regenerate an injured sports nerve.

It may be considered for selected patients and selected accompanying injuries after proper evaluation.

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Why ChiroMed Uses a Multi-Layered Approach

One strength of integrative care is that sports neuropathy may involve several problems at the same time.

Think of recovery as having several layers.

Layer 1: Protect the Nerve

The first step may include reducing movement, pressure, or activity that irritates the nerve.

Layer 2: Improve Mechanics

Chiropractic care and rehabilitation can address joint motion, posture, gait, and muscle control.

Layer 3: Rebuild Strength

Progressive exercise can restore strength, balance, stability, and athletic control.

Layer 4: Evaluate Medical Factors

Medical oversight helps identify metabolic or systemic conditions that could interfere with nerve health.

Layer 5: Consider Advanced Treatments

Laser, shockwave, targeted injections, or regenerative options may be considered when the diagnosis and evidence support their use.

ChiroMed’s integrated sports-care philosophy follows this broader model. The clinic combines chiropractic and rehabilitation services with medical and functional-health support rather than relying on one treatment alone.

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When Athletes Should Not Ignore Nerve Symptoms

Athletes often become used to soreness.

Neurological symptoms are different.

Seek prompt evaluation for:

• Increasing muscle weakness
• Foot drop
• Loss of grip strength
• Progressive numbness
• Muscle wasting
• Severe burning pain
• Major coordination changes
• Symptoms following a fracture or dislocation
• Persistent symptoms despite rest
• Loss of bowel or bladder control

Severe or rapidly worsening neurological symptoms may require urgent medical or surgical evaluation.

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ChiroMed’s Goal: From Nerve Pain Back to Better Movement

Sports neuropathy is not simply a pain problem.

A nerve can become irritated because of repeated compression, traumatic stretching, abnormal joint mechanics, inflammation, scar tissue, or another medical condition.

That is why treatment begins with finding the cause.

At ChiroMed – Integrated Medicine in El Paso, Texas, the broader strategy is to bring different areas of healthcare together.

Dr. Alex Jimenez’s chiropractic and rehabilitative approach can address movement, spinal and joint mechanics, posture, strength, and athletic function. Dr. Maria Guadalupe Cardenas provides internal medicine experience and medical oversight. Functional medicine can help evaluate nutritional and metabolic factors. Rehabilitation progressively rebuilds movement and performance.

Advanced modalities, targeted injections, and regenerative therapies may add another layer of treatment for carefully selected patients.

The goal is not to use every available treatment.

The goal is to build the right combination of treatments for the right athlete at the right stage of recovery.

For an athlete struggling with burning, tingling, weakness, numbness, or recurring nerve pain, an integrated evaluation may help uncover the source and create a clearer path toward improved function and a safer return to activity.

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References

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

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

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. MRI of sports-related peripheral nerve injuries

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

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

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

ChiroMed – Integrated Medicine. (2026). Regenerative therapies for athletes in El Paso, TX. Regenerative therapies for athletes in El Paso, TX

ChiroMed – Integrated Medicine. (2026). Regenerative medicine and chiropractic care in El Paso, TX. Regenerative medicine and chiropractic care in El Paso, TX