What Is Tarsal Tunnel Syndrome?

The tarsal tunnel is located on the inside aspect of your ankle on both feet (see the image below). The “tunnel” is a passageway for tendons, nerves, and blood vessels to pass from your calf to the bottom of your foot. With normal foot alignment, the tunnel has enough space to allow all the components in the tunnel to move freely without being compressed or putting on too much tension. However, pronated feet (also called “flat feet”) put excessive stress on the tarsal tunnel. Now why is this a problem?

What’s the Big Deal?

As it pertains to this discussion, the main player in tarsal tunnel syndrome is the tibial nerve, which is the nerve for the muscles and sensory receptors in the bottom of the foot. Likewise, common complaints that correspond with tarsal tunnel syndrome include both sensory and muscular changes, such as: numbness and tingling in the heel and/or bottom of the foot and weakness of toe muscles. Similarly, activities that involve moving the affected foot, such as walking, swimming, and standing, can cause pain. With all of these problems, what can we do to fix it?

So How Can You Fix This?

Currently, the literature is limited in the area of tarsal tunnel syndrome; however, there is some research to support both surgical and conservative treatments. Surgery involves relieving pressure in the area by cutting the “roof” of the tunnel (or the flexor retinaculum). Additionally, some surgeons elect to free up the tibial nerve and its branches from anything that may be adhered to the nerves. On the other hand, physical therapy offers a more conservative approach and can help to correct the issue of “flat feet” by supporting the arch of the foot, decreasing any inflammation with the use of modalities (which can include electrical muscle stimulation, traction, heat, ice, etc.), and breaking up any adhesions to the nerve using exercises aimed at targeting the tibial nerve and its branches.

For more information on tarsal tunnel syndrome or any other musculoskeletal complaints, contact Sports PT of NY at info@sptny.com.


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