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Tarsal Tunnel Syndrome Physiotherapy
Tarsal tunnel syndrome (TTS) is a condition that develops when a nerve
within the tarsal tunnel of the inner ankle is compressed. TTS can lead
to alterations in
- sensation and movement of the foot, ankle, and lower
- and/or pain
It is often associated with conditions causing
increased compression or swelling in the lower leg.
Our senior physitherapists
help patients with tarsal tunnel syndrome
What is Tarsal Tunnel Syndrome?
Often described as the carpal tunnel syndrome
or cubital tunnel syndrome of the lower extremity, tarsal tunnel syndrome is a condition that
results from the compression of the posterior tibial nerve as it runs
through the tarsal tunnel (a structure made up of bone and tissue
(retinaculum) on the inside of the ankle).
As it passes through the
tarsal tunnel, the tibial nerve divides into 3 branches that provide
sensation for the heel and bottom of the foot, and aid in the foot's
When this structure becomes compressed, symptoms, such as
- and/or tingling may occur and radiate into the lower
leg, foot, and toes
Patients may also experience muscle weakness in
How Does it Feel?
The most common symptoms of TTS result from irritation of the tibial nerve and its branches.
Patients with tarsal tunnel syndrome may experience:
- Pain, numbness, or tingling in the foot or ankle, which may radiate into the lower leg, foot, and toes
- Weakness in the muscles of the lower leg and foot
- Weakness of the big toe
- Foot swelling
- Symptoms that increase with prolonged 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?
There are several tests that can help a clinician determine if TTS is
present. Our senior physiotherapist and/or physician will first take a
comprehensive health history, and inquire about your current symptoms.
Then we may conduct tests, such as:
- Gently tapping over the posterior tibial nerve in an attempt to reproduce your symptoms.
- Tensing of the posterior tibial nerve, a maneuver that looks and
feels like a "stretch," in an attempt to reproduce your symptoms.
- Conducting a nerve condition study—a diagnostic test to determine the speed at which a nerve conducts information.
- Ruling out other conditions, such as plantarfasciitis (inflammation of the tissue that runs along the bottom of the foot).
how our senior physiotherapists can help
We can play a vital role in helping people experiencing
tarsal tunnel syndrome to improve and maintain their daily function and activities.
We will work with you to develop a treatment plan to
help address your specific needs and goals. Because the signs and symptoms of TTS can vary, the approach to care
will also vary.
We may provide the following
recommendations and care:
Nerve Gliding Activities
Gentle exercises that move and "glide" the nerves may help reduce symptoms and improve function.
Muscle Strengthening Exercises
Strengthening activities for any muscles affected by TTS, such as the tibialis posterior muscle in the back of your lower leg.
Balance and Coordination Activities
Work to improve your balance and coordination, which are often affected by TTS.
Apply ankle taping, a custom orthotic, or bracing to position the foot to decrease stress on the posterior tibial nerve.
As with many conditions, education is key. Understanding the
underlying mechanisms of TTS, and learning to recognize early signs and
symptoms of stress may help you better manage the condition.
Can this Injury or Condition be Prevented?
Although there are no proven strategies for preventing tarsal tunnel syndrome, there are
ways to minimize stress to the foot and ankle, such as
- wearing custom orthotics
- minimizing the amount of
time spent standing on hard surfaces
- improving and maintaining
strength in the muscles of your legs, ankles, and feet
can be discussed further with our senior physical therapists.
In addition, early detection of the signs and symptoms of TTS will
help you and your medical providers begin appropriate management of the
condition, which may enhance your long-term well-being.
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At the first session, our specialist physiotherapists will carry out a thorough
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Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
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