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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 leg
  • 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 function.

When this structure becomes compressed, symptoms, such as

  • pain
  • numbness
  • and/or tingling may occur and radiate into the lower leg, foot, and toes

Patients may also experience muscle weakness in the area.

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

  • choosing appropriate footwear
  • 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

These strategies 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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book your physio appointment or enquire now

Email questions and your preferred physiotherapy timings to nigel@phoenixrehabgroup.com or

WhatsApp / SMS your name, preferred date, time and enquiries to +6588001830

Clinic Locations: See how to get to us here

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Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.


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It is a system of safe and effective exercises, which meet specific individual needs, to treat a wide range of injuries and conditions.

You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.



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See our entire team here with introductions and their specializations.

At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.

Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

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book your physio appointment or enquire now

Email questions and your preferred physiotherapy timings to nigel@phoenixrehabgroup.com or

WhatsApp / SMS your name, preferred date, time and enquiries to +6588001830

Clinic Locations: See how to get to us here