Tarsal Tunnel Syndrome

Tarsal Tunnel Syndrome (TTS) occurs when a nerve within your ankle gets compressed. This can cause changes in your sensation, pain, or movement of the foot and ankle. It is commonly referred to as the carpal tunnel syndrome of the foot. Understanding more about this health condition can help you recover faster, get proper treatment, and prevent it from happening.

Tarsal Tunnel Syndrome

What is Tarsal Tunnel Syndrome?

Tarsal Tunnel Syndrome results from the compression of the posterior tibial nerve as it runs through the tarsal tunnel (a structure that is made up of bone and tissue on the inside of your ankle). As the nerve enters the tunnel it divides into 3 branches that provide sensation for the bottom of the foot and innervation to muscles that make your foot move. This compression can cause pain, weakness, and numbness. It is important to get early treatment as it could result in nerve damage. 

Tarsal Tunnel Syndrome

Symptoms of Tarsal Tunnel Syndrome

  • Pain, numbness, or tingling in the foot or ankle
  • Muscle weakness in the foot and ankle
  • Foot swelling
  • Symptoms that worsen with standing or walking
  • Symptoms that decrease with rest
  • Altered temperatures of the foot and ankle
  • Pain that disrupts sleep

How is Tarsal Tunnel Syndrome Diagnosed?

Your physical therapist will perform a few tests to determine if TTS is present. First, they will take a comprehensive health history. Then they will perform a physical examination. During the physical examination your therapist will perform the following:

  • Gently tap over the posterior tibial nerve 
  • Tensioning the posterior tibial nerve, to look for a reproduction of symptoms
  • Rule out other conditions, such as plantar fasciitis 

What are the risk factors for Tarsal Tunnel Syndrome?

  • Abnormal foot structures such as flat feet or high arches
  • Occupations that require long periods of walking or standing
  • Overweight
  • Previous history of ankle injuries
  • Medical conditions that cause edema such as arthritis, diabetes, or heart failure

How can I prevent Tarsal Tunnel Syndrome?

There are a few things you can do to help prevent TTS. The goal is to reduce stress on the foot and ankle. Appropriate footwear, and custom orthotics can help. Modifying activities to limit time spent walking on hard surfaces. A strength and flexibility program to maximize the mechanics of your foot can also help. These strategies should be discussed further with your physical therapist.

What will my PT have me do to recover from Tarsal Tunnel Syndrome?

The approach to treatment for Tarsal Tunnel Syndrome will vary from patient to patient. There are several key things that will be included:

Nerve glides: Gentle exercises that slide and glide the nerve. This can help reduce symptoms and improve mobility.

Mobility exercises: These exercises will help restore any motion that has been lost. Take a look at our ankle mobility series here for some exercises you might be doing with your PT.

Strengthening and endurance exercises: these exercises will target muscle of the foot and ankle that have weakened from the nerve injury. Examples are calf raises, and banded ankle movements.

Balance exercises: with this injury it is important to restore balance and coordination. Your physical therapist will have you do exercises while standing on one foot, eyes closed, and on different surfaces. 

Tarsal Tunnel Syndrome

If the injury is not getting better or you have any concerns, schedule an appointment with a Physical Therapist. At Symmetry Physical Therapy, our therapists are specially trained in a variety of areas to get you back to living the life you want as soon as possible! Our Physical Therapists will review your medical history and complete a thorough examination of your heel, ankle, and calf. Then they will assess your foot posture, strength, flexibility, and movement. All to determine the source of the problem and come up with a plan to recover and meet your goals.

How long will it take to recover from Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome can take anywhere from 2 weeks to 6 months. Once you begin therapy you will start to feel better. The time frame for recovery depends on the extent and cause of the nerve compression. Rehabilitation is important to restore ankle strength and balance and to prevent a recurrence. Seeing a Physical Therapist, who creates a plan tailored to your individual needs can be helpful in decreasing the recovery time and preventing a reinjury. So, if you have any questions or are looking to recover as soon as possible click here to schedule an appointment to see us today!

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