TARSAL TUNNEL SYNDROME
This simple nerve compression syndrome at the ankle requires only a few treatments to resolve.
Tarsal Tunnel Syndrome is a nerve compression of the main nerve that supplies the plantar surface (bottom) of the foot with sensation. It is located on the inside of the ankle, deeply situated underneath the large bone (medial malleolus).
Since Tarsal tunnel syndrome is a nerve compression syndrome, symptoms are exactly what you would experience in any nerve compression:
- Pins and needles sensations on the plantar aspect (bottom) of the foot
- Pain and/or altered sensations on the ball of the forefoot
- Feel like a small object is stuck inside the ball of the foot under the toes
- Buzzing sensations on the inside edge of the ankle and/or on the bottom of the foot
- Pain on the inside of the ankle just below the medial malleolus (large ankle bone)
- Stiffness on the inside aspect of the ankle extending upwards
- Pain or sensations of pressure up the inside of the lower leg
Tarsal Tunnel Syndrome occurs when the connective tissue on the lower leg and inside of the ankle joint becomes thickened, fibrotic thus squeezing the nerve. Various conditions may cause such connective tissue dysfunction which includes:
- Sudden weight gain
- Tendonitis of the tendons which pass onto the foot beside the main nerve being compressed
- Edema (Swollen ankle) joint due to trauma, water retention or joint arthritis
- Myofascial adhesion of the connective tissue which holds the nerve in its place
- Unaccustomed to walking long distance over uneven terrain
- Hypertension (High blood pressure)
- Knee arthritis
What Really Happens?
Nerves are extremely easy to compress when they surface from the protection of muscles to cross a joint. The peroneal nerve which passes onto the bottom of the foot is neatly tucked underneath the large bone on the inside edge of the ankle. It can’t be directly hit by outside forces as it is tucked up slightly behind the ankle bone. The only way to squeeze this nerve is to have a thickening of the connective tissue which surrounds and protects it. Nerves are susceptible to compression anywhere they turn to cross a joint. This is exactly what happens in tarsal tunnel syndrome.
Two treatments are required to resolve tarsal tunnel syndrome. Shockwave therapy is used to release the dysfunctional connective tissue from the region. Magnetic therapy is used to help regenerate any nerve fibres that show sign of damage. Neuromuscular therapy is used to resolve any other muscular or connective tissue dysfunctions that may exist from the knee down to and including the tendons of the foot.
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