Tarsal Tunnel Syndrome (TTS) is a nerve disorder cause by compression or squeezing of the nerve in the ankle and foot. It is similar to Carpal Tunnel Syndrome, which occurs in your wrist, however far less common. In Latin, ‘tarsal’ means ankle, therefore Tarsal Tunnel Syndrome results from compression or damage to the posterior tibial nerve located in your tarsal canal, which runs through the small space along the inside of your ankle into the heel and sole of your foot. It causes a lot of pain in your foot, ankle and toes. This condition is slowly progressive and occurs more commonly after 30 – 40 years of age.
Often damage to your posterior tibial nerve in one location may affect the overall functioning of your nerve, so you are more at risk of suffering from compression in other areas along the nerve. The nerve sends signals along its length and also moves its own nutrients, which is necessary for optimal function. Nutrients move along the entire length of your nerve via axoplasms (jelly-like material that fills the cells of the axons). If the flow of these nutrients is blocked, your nerve tissue further from the area of compression does not receive the essential nutrients to fight off injuries, and your damage will get worse.
Other names and/or similar conditions:
- Tarsal Tunnel Neuropathy
- Entrapment Neuropathy Of The Tibial Nerve
- Posterior Tibial Neuropathy
- Compression Of The Tibial Nerve
- Posterior Tibial Neuralgia
Tarsal Tunnel Syndrome Anatomy
The tarsal tunnel is found between the thick, overlying fibrous tissue on one side of your foot and the underlying bones on your other side. The flexor retinaculum acts as the top of your tarsal tunnel. It forms a deep, band of fibrous connective tissue that surrounds the muscles and nerves in your lower leg and ankle. The top of the Calcaneus (largest tarsal bone that makes up the heel), the inner wall of the Talus (2nd largest tarsal bone that forms the ankle joint connecting the leg bones to the foot bones) and the inner/bottom part of the Tibia (shinbone) comprise the bottom of your tarsal tunnel. Your ankle and foot tendons, muscles, nerve, artery and vein pass through the Tarsal Tunnel to get to the bottom of your foot.
Your Posterior Tibial Nerve is found between the Posterior Tibial Muscle, the Flexor Digitorum Longus and the Flexor Hallucis Longus muscles in your lower leg/ankle. The Tibial Nerve moves behind the bump on the inside of your ankle (Medial Malleolus) and through the Tarsal Tunnel, where it then divides into nerve branches in the sole of your foot.
Tarsal Tunnel Syndrome Symptoms
Although they vary from person to person, most of these symptoms are generally experienced on either the inside of the ankle and/or the bottom of the foot. The most common symptoms noted by those who suffer from Tarsal Tunnel Syndrome are:
- Tingling, burning, or prickling sensation (also known as paresthesias), in your foot (often in your arch, toe or heal).
- Vague or sharp pain, near the area where the nerve is squeezed (often in the sole of your foot, near your big toe, or along your nerve); this pain tends to be worse at night.
- Numbness, a loss of sensation in the area of skin that is supplied by the nerve.
- Atrophied (weakened) muscles in your inner foot (around the ball or arch of your foot) can affect your gait (the way you walk). You may have a tendency to overpronate (your foot rolls in too much), limp or feel uncoordinated as a result of too much pressure being placed on your foot.
- A lower foot deformity (like flat feet) can increase tension in the foot and may instigate the symptoms of TTS.
You can feel these symptoms on their own in one location or in various locations across your foot and lower leg. They can be aggravated by overuse of your foot through walking, exercising or prolonged standing. These symptoms will often subside with rest however they will not disappear.
If left untreated, you are at risk of suffering from permanent nerve damage.
Ankle Tendon Treatments
Allowing your ankle to rest is always recommended when you are suffering from tendinitis, tendon tear or bone dislocation. Avoid all activities that may have caused the injury or irritation and begin cold compression treatments as soon as possible. The peroneal and posterior tibial tendons are difficult to rest completely as they are essential tendons for walking and daily activities. During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your ankle until the pain and inflammation settle.
The trick with healing an ankle tendon injury is getting it to heal with minimal scar tissueformation. Even with optimum healing, there is always less elasticity in previously injured peroneal tendons. This will cause the tendons to hurt during daily activities and exercise. However, if you heal your ankle tendons efficiently and quickly, your chance of re-injury later on is much lower than average.
Fortunately, there are healing tools that can help treat your peroneal and posterior tibial tendons and speed up the healing process so you can get back to a life without pain and risk of further injury. Blood Flow Stimulation Therapy™ (BFST®) promotes blood flow to heal your tendons faster and more completely than any other methods available.