Tread Carefully with Tarsal Tunnel Syndrome

If you experience a burning or tingling pain in the sole of your foot, you might have tarsal tunnel syndrome. This condition can mean your foot “gives out” when performing certain physical activities. Tarsal tunnel syndrome occurs when there is abnormal pressure on the posterior tibial nerve in the foot. Pain worsens from activity, especially standing or walking for a long time. Eventually, your foot will start to feel numb or weak. Tarsal tunnel syndrome is similar to the more common carpal tunnel syndrome in the wrist. It could be caused by anything from swollen varicose veins to swelling from diabetes or inflammation in tissues around the nerve. Treatment involves taking the pressure off the nerve.

In some cases medication such as cortisone injections can help, while in others, surgery is needed. Physical therapy is a critical part of any treatment program for tarsal tunnel syndrome. Physical therapy also helps if you have pronation—flattened arches that can lead to tarsal tunnel syndrome. To take the tension off the nerve, we will find the best orthotic inserts for your shoes to support your arch. Other treatments include ice packs, hydrotherapy, soft tissue massage, taping the foot and electrical stimulation.

Because tarsal tunnel syndrome makes movement painful, physical therapy is key to safely regaining strength and mobility. You will perform active movements and range-of-motion exercises focusing on the ankle and toes. We will provide exercises to strengthen the muscles that support the ankle and arch. Special stretches will mobilize the affected nerves. The goal of such exercises is to

  • control pain, swelling and inflammation
  • protect the joint and nerve from injury
  • ensure normal gait mechanics for walking and running
  • support your return to sports and other activities

It is important that we provide an exercise program because there is the potential to place excessive stress on the ankle and foot. The good news is that with regular physical exercises, you can manage tarsal tunnel syndrome and again enjoy pain-free, normal steps and movement.