Tarsal Tunnel Syndrome

The tarsal tunnel lies within the ankle and houses important nerves, arteries, tendons and suchlike, one of which is the posterior tibial nerve. This nerve, when unnaturally pinched, causes tarsal tunnel syndrome and affects the foot, occasionally spreading up the leg. It is comparable to carpal tunnel syndrome of the wrist.

Symptoms

Pain, numbness, and a feeling like pins and needles or burning can all be present on the inside of the foot, in the area surrounding the ankle. These symptoms also regularly arise on the bottom of the foot, and may not be confined to one area. The toes, foot arch, heel or calf muscle can all be affected. The presence of any of these symptoms should be taken seriously. They can strike without warning, or increase gradually in severity. As soon as any of the symptoms are recognised, consult a doctor in order to avoid long term nerve damage.

Causes

Athletes often sustain the injury over time through overuse of the affected foot. This can include running, walking or otherwise training on a leg for extensive periods, not taking enough breaks for rest, or exercising with weakened or fatigued muscles. Suddenly increasing a training routine to a strenuous level, or changing from little to huge amounts of exercise, can also provoke the condition. Another risk factor is flat feet (possessing flattened arches), as this causes the heel to bend outwards and puts greater pressure on the posterior tibial nerve. Sometimes another ankle injury can lead to tarsal tunnel syndrome. Other conditions that can potentially compress the nerve include an inflamed tendon or varicose vein, and diseases including arthritis and diabetes.

Medical Treatment

Consult a medical professional who will perform a physical exam to check for symptoms and any numbness or unusual masses. Depending on the severity of the injury they may recommend treatments such as implementing a cast to hold the joint in position as it heals, injecting corticosteroids to reduce inflammation, or using a brace to combat pressure to the ankle. A physical therapist can advise on specific gentle exercises to maintain foot mobility without worsening the pain. If these measures and your own rest and self-treatment fail, or if the initial injury is major, surgery can be required.

If the injury was caused due to a biomechanical fault in the foot, the doctor may suggest wearing shoe inserts (or orthotics) to correct the problem. Certain types of supportive shoe can also be valuable in many cases.

Self-Treatment

In combination with the above, it is important to rest the affected area responsibly until it recovers. This means refraining from placing strain on the foot, both in sports and regular activities such as walking. However, with support from a doctor you should endeavour to continue some form of movement to avoid possible stiffness. Ice the area for 15 minutes a few times per day to help relieve pain and swelling. Anti-inflammatory medication like ibuprofen can also be beneficial.

Prevention

Take breaks during exercise in order to avoid overuse injuries. Learn to recognise what constitutes a suitable amount of training. Identify and amend any problems with your feet so that they are not put under inordinate pressure.