Tarsal Tunnel Syndrome (Ankle Nerve Entrapment)
The tarsal tunnel is a narrow tunnel on the inside of the ankle, just below the bony bump (medial malleolus) and towards the back of the heel. It is a channel for tendons, arteries and nerves to pass through, and is secured by a connective tissue called the flexor retinaculum that covers the channel.
The tibial nerve passes through this tunnel and splits into two branches, called the medial and lateral plantar nerves. Nerves give sensation to the feet.
Tarsal tunnel syndrome (TTS) describes the compression of and damage to the tibial nerve as it passes through the tarsal tunnel and beneath the connective tissue sheath (flexor retinaculum).
While some cases of tarsal tunnel syndrome have can have no attributed cause, tibial nerve compression can be caused by:
Pain and tenderness may be present in the region of the tarsal tunnel on the inside of the ankle, particularly where swelling is present. Symptoms can come on suddenly or gradually, and are typically neural in nature. Symptoms are often aggravated by movement and include:
Because the tibial nerve and its branches give sensation to the heel and the bottom of the foot, this is where neural symptoms are experienced. Pain can radiate into the arch and present as heel pain. Being able to pinpoint the affected areas can be a valuable diagnostic tool in helping identify the point at which the nerve is compressed and better direct treatment.
While initially rest, ice and anti-inflammatories may help reduce painful symptoms, treating tarsal tunnel syndrome is centred around treating the particular cause of the nerve compression where it is known or deduced. Your Podiatrist will run through a thorough exam to assess the function and characteristics of your feet and legs. Management may include:
Because permanent nerve damage can occur if proper care is not taken, it is important to seek treatment if you suspect you may have tarsal tunnel syndrome.