Common fibular nerve compression

A numb shin, past injuries, and a tingly ankle two months later

April 2, 2025

Part 1: Numb shin

I had a nerve compression of my common fibular (peroneal) nerve in my left leg from a suspension tie in November that caused the muscle next to my shin to go numb for 21 days. Later in January I then got a sensory nerve compression on the top of my left foot that’s suspected to be semi related to the shin injury, with past injuries being a contributing factor.

Rigger involved is @ Parlourhax , he agreed to be mentioned and helped proofread.

The tie & shin injury

The tie was an M-shape tied to bamboo. Upper body tie was a hands free chest harness that was side loaded. Skipping the other details because it’s a pain to explain the full tie without photos. Important part is my left leg had a single column on my upper thigh that was locked off to the bamboo (pulling directly up), and there was a single column on my thigh close to my knee that was pulled away from my body and locked off to bamboo. My left leg was bent and my ankle was roughly tied to my other foot to keep my leg bent. Majority of my weight was distributed between the chest harness and the single column close to my knee.

During the suspension I did not notice nerve issues with my left leg, Hax did check in when I was struggling more than what was expected and I was able to communicate circulation was going in my left leg.

Once I was out of the tie and back on the ground I noticed my left shin was numb, specifically the muscle next to my shin bone from knee to ankle was numb. I believe I said something like ‘my shins numb’. I proceeded to check sensation and strength of the rest of my body, finding only sensory issues with my shin. Hax suggested I stand to help get blood flow to the area and I took ibuprofen. Sensation did not change.

From discussing it with Hax and researching we were able to confirm the cuff close to my knee had slipped up towards my knee because the cuff was pulled away from my body. It had likely slipped up in the back, so pressing into above my left knee on the outside of my leg, without us noticing since Hax stayed in front of me for most of the tie.

In later discussions Hax noted loading thighs near the knees has taught him to not fold the leg under load, it shifts compressed muscles in unnatural ways.

With some research I worked out it was likely a compression of the common fibular nerve from above my knee, affecting the superficial fibular nerve. Although, it could have been the compression of having my leg bent and pressing into above my calf. The single column affecting my lower leg’s circulation was a factor to this injury as well.

The superficial fibular nerve relays sensory from the dorsum of the foot and anterolateral leg (Meadows & Finnoff, 2014), in context of my shin the numbness felt next to my shin bone is most likely from compression of the superficial fibular nerve.

Healing

For the following 21 days my shin slowly returned in sensation, Hax checked in and I kept him updated on sensation status. I kept rope entirely off that leg and hip (mostly, I wasn’t perfect about it with my self tying), letting it rest. From that injury there was no lasting effects, although I’m very mindful of that shin and ties close to the knee going forward.

I was seeing a physiotherapist at the time for my shoulder, I mentioned it to them and they weren’t able to help much. I knew how to heal and care for it given my experience with my shoulder injury. I returned to physical activity to help get blood flow to the area, albeit maybe a bit too quickly but no harm done with my shin so far.

Injury part 2: the ankle sensory nerve compression

I do acknowledge I was potentially a bit too quick to put rope on that leg, I did leave some time (a few weeks) between sensation returning and putting rope on it.

Ankle injury presentation

In January I got a sensory nerve compression on the top of my left foot, the superficial fibular nerve compressed on the anterior section of my ankle (Fortier et al., 2021; Meadows & Finnoff, 2014). I think it was from a tie with Hax that had foot torture elements, painful binding around my feet when they were pointed, rope pressing into the top of my feet and using my toes. It was only noticed almost a few days after the tie when I probed my foot.

It presented as tingling when the top inner part of my foot was touched, as if I could press on the nerve and feel it tingle back, specifically between the talus and navicular. From there when it was aggravated it was dull pain along the arch of my foot, occasional slight burning sensations. Pressure from my boots made it worse, as did standing for long periods, jumping/landing on it. I since worked out dorsilflexion/flexed foot with weight on it, often with my foot arch collapsing, is the main position that upsets it and I’ve avoided that foot position since while it was healing. I swapped my insoles to an older pair too and that helped immensely with arch support. My hypermobility and prior injury is slowing down the healing.

The injury impacted my ability to walk long distances, as well as some of my daily life. This went on until end of May and varying levels of no pain to flare ups. As I write this I’ve been without issues for roughly two months (one or two flare ups that resolved and settled down), I’m tentatively hopeful.

Connection to my shin

The dominant theory is double crush syndrome for the common fibular (peroneal) nerve, the nerve at my ankle being the same one that was affected behind my knee. The superficial fibular nerve is the one that caused my shin to go numb, and the superficial fibular nerve is what is strongly theorised to be compressed at my ankle. Note: Double crush syndrome is still debated in medical literature, from what I’ve found there’s evidence to potentially indicate it’s a thing, but it’s ill defined and still needs more research (Cohen et al., 2016; Kane et al., 2015; Mills et al., 2022). Hence, there’s a potential I am wrong and these are two seperate nerve injuries that are unrelated.

A very large factor to the ankle injury is the significant prior injuries I have had to my left ankle. I only discovered the full extent of those injuries in May, prior to May I knew I had a stress fracture in 2018 and that it had since healed - discovered that ‘stress fracture’ is putting it mildly.

As I’ll repeat later, if I knew my ankle was, well, fucked in the way it is I would have avoided rope being on it in that way.

Side tangent on my previous injuries to my left ankle

Prior to May of this year I have been working off the basis that my right ankle has been the one to avoid foot torture. After getting a recent MRI in June and reviewing a 2018 MRI result I didn’t previous have access too, yeah no left ankle is more fucked than my right actually.

2018 ankle injury presentation

I was a gymnast up until end of 2018. From January 2018 to roughly June 2019 I was experiencing chronic pain on the inside of my left foot, especially at the arch and big toe joint. In July 2018 I got an MRI that explained why but was only really informed about a stress fracture, although I’ll admit it was a high anxiety appointment so memory is foggy.

2018 MRI results

I had impaction fracture to my talus and a ostechondral fracture of my medial cuneiform. As well as a rupture of the medial sesamoid phalangeal ligament and a medial plantar plate tear. And to copy from the MRI results from 2018, “Likely chronic partial tear of the lateral sesamoid phalangeal ligament. Secondary synovitis within the first tarsometatarsal joint and the first MTP joint.”

Synovitis - swelling/inflammation in the synovial membrane;, the synovial membrane is the tissue that lines the inner surface of some of a bodies joints (Dumain, 2019; Juneja et al., 2024).

2025 MRI results

MRI spotted the old fracture, noting swelling of the joint in the area. Subchondral cyst in the medial cuneiform with swelling of the joint. Inflammation of the joint tissue in some areas. Remodeled old osteochrondral fracture of the head of the talus.

Osetochrondral fracture - fracture that involves both underlying bone (subcondral) and cartilage (Steffes & Szatkowski, 2024).

Subcondral cyst - fluid filled sac that forms in the bone below the cartilage of a joint the region beneath the cartilage in a joint [fun fact - occasionally referred to as a geode] (Eustice, 2024).

Short recap in plainer words

Two prior stress fractures, inflammation/swelling of joints, cyst where a fracture was, changes to my foot bones/joints/cartilage that mean my foot no longer allows for a proper range of motion when I land on my feet/bear weight with my knee going over my toe. I can’t do high impact sports like gymnastics or running without risk of injury.

If I knew this prior to getting into rope I would have avoided torture rope to my left foot. I can see how this was a contributing factor to the sensory nerve compression of my ankle, with the superficial fibular (peroneal) nerve compression being the final nail in the nerve compression coffin as to why it happened then but not previously without rope. Prior injury also contributed to slower healing.

Reflections & take aways

• Post tie I’ve now found out the hard way about the direction an upline is pulled. I’m mindful of uplines close to the knee joint when I’m tying or someone is tying me, I try to stick to the rule that I need to direct the upline reverse of where it could slip to. So for the case of a single column above my knee, pull the upline towards my body instead of away. An alternate approach is put the single column higher and tighter on my thigh, or use a thigh harness that won’t slip up, jute can be great at gripping to skin.
• I’m also now mindful of checking sensations throughout a tie. When I’m being tied I might to ask for someone to run their nails along my skin in areas I’m worried about. Or if my hands or a limb is free I’ll do it myself. I do the same for self tying and the people I tie (I’ll openly admit, I need to do it more often). It’s been helpful in giving me peace of mind and being able to identify what’s going on.
• I’ve learned the hard way that I need to let my body heal. With a shoulder injury, numb shin, and then a sensory nerve compression in my foot, plus a weird nerve things in my left hand for a few months, I made the decision in January to April to pause rope bottoming. If I was injured again while healing those injuries then the potential impact was out of my risk profile. I chose to continue self tying because I could control where the rope went and I could feel the moment something felt wrong (didn’t mean I didn’t often flare up my shoulder but kind of unavoidable when I didn’t know the cause of shoulder injury for 6+ months).
• Side note, you’d be surprised how annoying it is to not have a left ankle/leg to put a single column on for dynamic self tying, especially when you don’t enjoy gun slingers. Even more annoying when your left arm can do fuck all with holding your own weight without significant pain for a week.
• And for future me, keep the fucked up foot rope torture to my right foot or just to toes.
• A tool I’ll use or lightly enforce in future when relevant is visually indicating injured zones on my body. I know it can be hard to remember which ankle or which arm is injured in the moment and I’d rather having a physical reminder for my own mental well-being than having to be overly hyper vigilant if the person tying/playing with me has forgotten. This could be a ribbon, keeping a sock on, writing on my own skin, etc. Forgetting is not a personal failure of a rigger, some people struggle with working memory for a variety of reasons and I will always happily work with folks to accomodate it.
• My approach to nerve injuries I get now is: Leave it alone. Don’t massage, don’t stretch it, don’t put rope on it. Let it rest, take anti-inflammatories after injury. And to a friend who’s told me to give it more time once it feels like it’s healed, thank you, you’re right and I wish I followed your advice sooner. Once it’s ready, as advised by my exercise physiologist, get blood flow to the area to help it heal.
• Injuries happen, they will stay with a body and mind. Repeated injury within a short span of time has had a big impact on my ability to feel comfortable being tied. While I conceptually understood the risks and that I might get injured, being faced with the experience of two/three nerve injuries within four months introduced a fun new element of fear play to rope I didn’t have on my consent sheet between me, myself and I (sarcastic joke). I adore being tied, but surrendering in a tie isn’t an easy thing these days.

Rope resources

Some of my favourite resources for rope and nerves are

1. ropestudy’s page on Nerve & Circulation
2. Rope365’s pages on Upper Limb Nerves , Lower Body Nerves
3. The book ‘Better Bondage for Every Body’ by Evie Vane

References

1. Cohen, B. H., Gaspar, M. P., Daniels, A. H., Akelman, E., & Kane, P. M. (2016). Multifocal Neuropathy: Expanding the scope of double crush syndrome. The Journal of Hand Surgery, 41(12), 1171–1175. https://doi.org/10.1016/j.jhsa.2016.09.009
2. Dreyer, M. A., & Gibboney, M. D. (2023, May 23). Anterior Tarsal Tunnel syndrome. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK538488/
3. Dumain, T. (2019, March 8). What is synovitis, and how does it affect arthritis? CreakyJoints. https://creakyjoints.org/education/what-is-synovitis/
4. Eustice, C. (2024, May 5). Subchondral bone cysts in people with osteoarthritis. Verywell Health. https://www.verywellhealth.com/what-is-a-subchondral-cyst-2552235
5. Fortier, L. M., Markel, M., Thomas, B. G., Sherman, W. F., Thomas, B. H., & Kaye, A. D. (2021). An update on peroneal nerve entrapment and Neuropathy. Orthopedic Reviews, 13(2). https://doi.org/10.52965/001c.24937
6. Juneja, P., Munjal, A., & Hubbard, J. B. (2024, April 21). Anatomy, joints. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK507893/
7. Kane, P. M., Daniels, A. H., & Akelman, E. (2015). Double Crush syndrome. Journal of the American Academy of Orthopaedic Surgeons, 23(9), 558–562. https://doi.org/10.5435/jaaos-d-14-00176
8. Lowe, W. (2003). Foot, ankle, and lower leg. In Elsevier eBooks (pp. 61–85). https://doi.org/10.1016/b978-072343226-5.50011-3
9. McAnally, H. (2016). Lateral sural cutaneous nerve entrapment. In Springer eBooks (pp. 811–817). https://doi.org/10.1007/978-3-319-27482-9_72
10. Meadows, J. R., & Finnoff, J. T. (2014). Lower extremity nerve entrapments in athletes. Current Sports Medicine Reports, 13(5), 299–306. https://doi.org/10.1249/jsr.0000000000000083
11. Mills, E. S., Mertz, K., Fresquez, Z., Ton, A., Buser, Z., Alluri, R. K., & Hah, R. J. (2022). The incidence of double crush syndrome in surgically treated patients. Global Spine Journal, 14(4), 1220–1226. https://doi.org/10.1177/21925682221137530
12. Osteochondral fracture of the talar dome - ankle - conditions - musculoskeletal - what we treat - physio.co.uk. (n.d.). https://www.physio.co.uk/what-we-treat/musculoskeletal/conditions/ankle/osteochondral-fracture-of-the-talar-dome.php
13. Steffes, M. J., & Szatkowski, J. (2024, June 1). Osteochondral Lesions of the Talus. Ortho Bullets. Retrieved August 19, 2025, from https://www.orthobullets.com/foot-and-ankle/7034/osteochondral-lesions-of-the-talus
14. TeachMeAnatomy. (2024a, January 4). Muscles of the anterior leg - Attachments - actions - TeachMeAnatomy. https://teachmeanatomy.info/lower-limb/muscles/leg/anterior-compartment/
15. TeachMeAnatomy. (2024b, March 30). The common fibular nerve - course - motor - sensory - TeachMeAnatomy. https://teachmeanatomy.info/lower-limb/nerves/common-fibular-nerve/