Sophia is a 16-year-old soccer player who loves the game with all her heart and her goal is to play soccer in college. To accomplish this she trains five days a week, takes the sport seriously, and does all sorts of stretching and strengthening exercises to keep her body in top shape. However, over the past year, Sophia has increasingly been experiencing heavy fatigue in her calves, numbness into her feet, and cramping in her hamstrings during and after her soccer games and practices. It’s been really frustrating for her, as she doesn’t understand why her legs hurt when she plays. Despite her best efforts, the pain and discomfort in her legs just wouldn’t go away. Sophia saw her medical doctor for help, but they did not provide much assistance. All they did was send her a generic video about stretching, which she felt was a waste of her time and money. When she went back and was diagnosed with a hamstring strain she nearly lost it because she knew a hamstring strain couldn’t cause her feet to go numb and her calves to cramp. She was completely distressed when she had to sit out of an important soccer college showcase where many scouts were watching. It wasn’t until she saw a physical therapist at Prevent Physical Therapy, INC that she learned she had symptomatic bilateral lower extremity neural tension, learned what she could do about it, and was able to return to the pitch and get recruited for college soccer. In this blog post, we’ll be exploring what lower extremity neural tension is, how it affects soccer players, and most importantly, what you can do to prevent and treat it with the help of an expert physical therapist.
What is neural tension?
As a soccer player, you rely heavily on your lower extremities to run, kick, jump, and move around the field. However, when there is tension or compression on the nerves in your legs and feet, it can lead to a host of painful and limiting symptoms that can negatively impact your performance on the field. This is known as lower extremity neural tension, and it affects athletes of all ages and skill levels.
Neural tension refers to the pressure or stress placed on nerves throughout the body resulting in adverse symptoms. This results from the inability of the nerves to move through tissue. Nerves are unique in that they do not have an elastic component to them and they move through tissue like a piece of floss in a tooth. If you tug on one end the other end will pull in the same direction. If the nerves are compressed or stretched beyond their normal limits, they loose the ability to ‘floss’ which in turn can cause nerve trauma resulting in a variety of symptoms such as pain, tingling, numbness, and weakness.
Neural tension can occur as a result of poor posture, muscular imbalances, repetitive activities, or injuries such as ankle sprains or knee injuries. The most common cause is related to muscular tightness in areas the nerves moves through. One common area is compression in the low back. When this happens pain often radiates down the leg, called sciatica. Other areas of that compression can occur are at the piraformis muscle in the glute (piraformis syndrome), in the hamstring after a muscular strain, in the calf (exertional compartment syndrome), and around the medial ankle (tarsal tunnel syndrome). Often times mild compression at one of these sites is not enough to elicit symptoms, however when mild compression occurs at multiple sites along the nerve pathway symptoms may begin. This phenomenon is known as double crush and often times gets miss diagnosed in it’s early stages.
When it comes to soccer players, lower extremity neural tension is particularly common due to the high-impact nature of the sport, as well as the repetitive movements and positions involved in training and playing. This leads to many areas of stiffness that can add compression onto the nerves ultimately causing pain. It’s important for soccer players to be aware of the signs and symptoms of neural tension and to seek treatment early on to avoid further damage and potential long-term consequences.
How do I know I have neural tension?
The signs and symptoms of lower extremity neural tension in a soccer player can vary depending on the specific nerve affected and the severity of the tension. Some common signs and symptoms may include pain or discomfort in the feet, ankles, calves, or thighs, especially during or after exercise; numbness or tingling in the toes or other areas of the foot; weakness or loss of sensation in the affected area; and difficulty with certain movements or positions. It’s important to note that not all cases of neural tension present with clear symptoms, and some athletes may not even be aware that they have a problem until it begins to interfere with their performance or daily activities. If you’re experiencing any of these symptoms or suspect you may have neural tension, it’s important to consult with a physical therapist who can help diagnose and treat the problem.
What do I do if I suspect I have neural tension?
If you’re experiencing symptoms of lower extremity neural tension, the first step is to schedule an evaluation with one of Prevent Physical Therapy’s physical therapists who can help diagnose and treat the problem. During your evaluation, your physical therapist will conduct a thorough assessment to identify any underlying factors contributing to your neural tension symptoms. Our physiotherapists follow a systematic evaluation process that looks at your sport specific movements. If deficits are noted then we break down the faulty movements to diagnose the root cause of the problem and then create individualized corrective programs to improve your movements and decrease your pain.
Physical therapy can be an effective treatment for many cases of lower extremity neural tension caused by more benign factors, such as poor posture or muscular imbalances. Treatment approaches may include manual therapy techniques such as joint mobilization, instrument assisted soft tissue mobilization or manual soft tissue mobilization to help release tension in the affected area. Stretching exercises can also be beneficial for improving flexibility and reducing nerve tension. Massage or foam rolling can be used to help break up adhesions or scar tissue and improve circulation in the affected area. In most cases, a technique called nerve flossing will be used, which involves gently stretching and mobilizing the nerves through the compressed areas after they are loosened up to help reduce tension and improve function. If there are any underlying muscle weakness or imbalances that may be contributing to your neural tension our therapists will develop specific strength and conditioning exercises to address the findings. By addressing these factors and implementing an appropriate treatment plan, many soccer players can find relief from their neural tension symptoms and return to the field with improved function and performance.
Differential Diagnosis
While many cases of lower extremity neural tension can be treated effectively with physical therapy and other conservative measures, some cases may require more extensive medical intervention. Severe or chronic cases of neural tension can be caused by underlying conditions such as lumbar compression, spondylolisthesis, or exertional compartment syndrome in the calf. Lumbar compression occurs when there is pressure on the nerves in the lower back, which can lead to radiating pain or weakness in the legs. This is commonly know as sciatica. Spondylolisthesis is a condition in which a vertebra in the spine slips out of place and compresses the nerves in the lower back and legs. Exertional compartment syndrome is a condition in which the muscles in the lower leg become too large for the compartment they are contained in, leading to pressure on the nerves and blood vessels in the area. If we suspect that you may have one of these more severe causes of neural tension, we will recommend that you seek medical attention from a doctor who can help diagnose and treat the problem appropriately. In most cases exercises prescribed in PT can still help manage and speed up the recovery when a more severe cause is known.
Take Action
Neural tension is a complicated diagnosis and there are many potential causes to it. If you suspect that you or someone you know may be suffering from lower extremity neural tension, don’t wait to seek help. At Prevent Physical Therapy, INC, we specialize in diagnosing and treating neural tension in soccer players and other athletes. We offer a free 15-minute call or in-office screen to help you determine if physical therapy is the right choice for you. Our expert physical therapists will work with you to develop an individualized treatment plan that addresses your unique needs and goals, helping you get back to doing the things you love without pain or discomfort. Contact us today to schedule your free consultation and take the first step towards finding relief from neural tension.