1621 - “You’ve got some nerve!”: Boomer’s Peroneal Nerve Definitely Not Okay - A Case of Neuropathy

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

JJ

Jeffrey Joseph, n/a

Medical Student
Nassau University Medical Center (NUMC)
Jackson, New Jersey, United States

Co-Author(s)

CK

Chi Lam Kwok, DO

PM&R Resident
Nassau University Medical Center
Rego Park, New York, United States
JW

Justin Wang, MD

PM&R Resident Physician
Nassau University Medical Center
East Meadow, New York, United States
BF

Brent Fogel, DO

PM&R Resident
Nassau University Medical Center
Melville, New York, United States
FB

Forrest Butensky, DO

PM&R Resident Physician
Nassau University Medical Center
East Meadow, New York, United States
RC

Ricardo Cruz, MD

Director, Physical Medicine and Rehabilitation
Nassau University Medical Center
East Meadow, New York, United States

Submitter(s)

JJ

Jeffrey Joseph, DO

Nassau University Medical Center (NUMC)
Jackson, New Jersey, United States

Case Diagnosis: A 78-year-old male with a history of hypertension and hyperlipidemia presented with right-sided foot drop. The onset occurred after prolonged leg crossing while waiting at an airport. The patient reported numbness and weakness upon standing, without any trauma, low back pain, or bladder/bowel changes. The episode had occurred eight months prior to presentation.

Case Description: Physical exam revealed 4+/5 strength in the right tibialis anterior with otherwise normal strength, intact sensation, and mildly diminished deep tendon reflexes. Gait was independent with normal heel-toe walking. After six months of persistent symptoms, the patient underwent a nerve conduction study that revealed decreased conduction velocity in the right peroneal motor nerve. EMG showed no electrical instability. The patient completed physical therapy and performed home exercises.

Discussions: Foot drop typically results from common fibular nerve compression, which may occur from leg crossing or squatting. Given the nerve’s superficial location near the fibular head, it is vulnerable to compressive forces. Diagnosis involves clinical exam, electrodiagnostic studies, and differentiation from L5 radiculopathy. Conservative treatment includes foot orthoses and physical therapy. Severe cases may require tendon transfer surgery to restore dorsiflexion.

Conclusions: This case illustrates how prolonged or habitual postures, such as leg crossing, can lead to compressive neuropathies like foot drop. Early recognition and management are key to preserving function. Conservative treatment led to improvement in this case, thus revealing the importance of awareness, diagnosis, and rehabilitation.