Written by: Dr. Evan Steinke, B.Sc, DC
Your foot and ankle are hosts to a considerable number of arteries, tendons, and nerves. These
structures have weaved in and around bones with very limited space. In the case of Tarsal
Tunnel Syndrome (TTS) they pass through a rather small tunnel where they have the potential
to be compressed. As a result, patients may suffer from pain at and below the point of
compression. This leads to the characterized pain along the inner ankle and sole of the foot
possibly with numbness or tingling. In some cases, it may feel like a burning sensation and be
accompanied by weakness of the foot muscles.
The tarsal tunnel itself is comprised of two main structures, the base and the roof. The base of
the tunnel is created by a concave in the bones of the feet with one peak being the ankle and
the other being the innermost part of the heel. The second structure is a fibrous connective
tissue running between the two peaks essentially acting as a roof and creating the tunnel. The
tunnel is filled by three tendons, an artery and vein, and the tibial nerve. Due to the high number
of structures running through a closed, narrow space any amount of swelling or inflammation
can lead to compression of the tibial nerve. It is this compression that causes the symptoms of
TTS such as the pain and tingling sensation.
Treatment is based on trying to relieve pressure on the tibial nerve as it enters and passes
through the tarsal tunnel. This often includes trying to reduce swelling and inflammation of
surrounding tissue or injuries, especially to any tendons that directly pass through the tunnel
itself. This may include icing or resting protocols or over-the-counter anti-inflammatories.
Adjustments to the base of the tunnel may be performed if there are any bony malalignments.
Additionally, soft tissue massage or ART/MRT may be applied to tight muscles to try and
alleviate pressure from the nerve.
If you are looking to book a personal assessment to get to the source of your hip pain book in at either AST location. Our many expert practitioners will assist you in your journey toward better hip mobility. If you are looking to book in with Dr. Evan Steinke, he works at AST Westman.
*The content contained in this blog is provided for general information purposes only. The above content is general suggestions and not intended to replace the services of a trained physician, physical therapist or chiropractor or otherwise to be a substitute for professional medical advice, diagnosis, or treatment.
