Tarsal tunnel syndrome (TTS) is a condition that results from compression or entrapment of the posterior tibial nerve within the tarsal tunnel of the medial ankle giving symptoms of numbness, burning, and paresthesias in the heel, ankle, or sole of the foot (1). TTS can have several potential causes including trauma, soft tissue inflammation, and compression lesions (1). It is similar in presentation to a carpal tunnel injury in the wrist.
Physical therapy can help manage symptoms of TTS. A physical therapist may use manual techniques, such as massage or stretching, to alleviate tension and promote mobility in the affected area in order to reduce pain and improve function. Your physical therapist will also work with you to help identify any potential drivers for the problem if there is weakness or tightness in the lower quarter and will work with you to design an exercise program that includes stretches and strengthening exercises for the foot, ankle, and lower extremity to improve movement, balance, and stability.
Treatment for TTS may also involve conservative measures such as rest, ice, heat, non-steroidal anti-inflammatories, etc (1). Surgical intervention may be necessary in some cases where conservative measures fail (1). Early diagnosis and treatment can help improve outcomes and prevent further complications of tarsal tunnel syndrome.
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Fortier LM, Leethy KN, Smith M, McCarron MM, Lee C, Sherman WF, Varrassi G, Kaye AD. An Update on Posterior Tarsal Tunnel Syndrome. Orthop Rev (Pavia). 2022 May 31;14(4):35444. doi: 10.52965/001c.35444. PMID: 35769658; PMCID: PMC9235437.