Tarsal Tunnel Syndrom
Tarsal Tunnel Syndrome (TTS) is known as a compression neuropathy (nerve disorder due to squeezing of the nerve) in the ankle and foot. It is similar to Carpal Tunnel Syndrome, which occurs in your wrist, however far less common. Tarsal Tunnel Syndrome results from compression or damage to the posterior tibial nerve located in your tarsal canal, which runs through the small space along the inside of your ankle into the heel and sole of your foot. It causes a lot of pain in your foot, ankle and toes. Often damage to your posterior tibial nerve in one location may affect the overall functioning of your nerve, so you are more at risk of suffering from compression in other areas along the nerve. The nerve sends signals along its length and also moves its own nutrients, which is necessary for optimal function. If the flow of these nutrients is blocked, your nerve tissue further from the area of compression does not receive the essential nutrients to fight off injuries, and your damage will get worse.
Tarsal Tunnel Syndrome Anatomy
The tarsal tunnel is found between the thick, overlying fibrous tissue on one side of your foot and the underlying bones on your other side. The flexor retinaculum acts as the top of your tarsal tunnel. It forms a deep, band of fibrous connective tissue that surrounds the muscles and nerves in your lower leg and ankle. The top of the Calcaneus (largest tarsal bone that makes up the heel), the inner wall of the Talus (2nd largest tarsal bone that forms the ankle joint connecting the leg bones to the foot bones) and the inner/bottom part of the Tibia (shinbone) comprise the bottom of your tarsal tunnel. Your ankle and foot tendons, muscles, nerve, artery and vein pass through the Tarsal Tunnel to get to the bottom of your foot.
Your Posterior Tibial Nerve is found between the Posterior Tibial Muscle, the Flexor Digitorum Longus and the Flexor Hallucis Longus muscles in your lower leg/ankle. The Tibial Nerve moves behind the bump on the inside of your ankle (Medial Malleolus) and through the Tarsal Tunnel, where it then divides into nerve branches in the sole of your foot.
Symptoms of Tarsal Tunnel Syndrome
Although they vary from person to person, most of these symptoms are generally experienced on either the inside of the ankle and/or the bottom of the foot. The most common symptoms noted by those who suffer from Tarsal Tunnel Syndrome are:
- Tingling, burning, or prickling sensation in your foot
- Vague or sharp pain, near the area where the nerve is squeezed (often in the sole of your foot, near your big toe, or along your nerve); this pain tends to be worse at night.
- Numbness, a loss of sensation in the area of skin that is supplied by the nerve.
- Atrophied (weakened) muscles in your inner foot (around the ball or arch of your foot) can affect your gait (the way you walk). You may have a tendency to overpronate (your foot rolls in too much), limp or feel uncoordinated as a result of too much pressure being placed on your foot.
- A lower foot deformity (like flat feet) can increase tension in the foot and may instigate the symptoms of TTS.
You can feel these symptoms on their own in one location or in various locations across your foot and lower leg. They can be aggravated by overuse of your foot through walking, exercising or prolonged standing. These symptoms will often subside with rest however they will not disappear. If left untreated, you are at risk of suffering from permanent nerve damage.
Treating Tarsal Tunnel Syndrome
Rest, Ice, Compression and Elevation
When treating Tarsal Tunnel Syndrome, rest the area as much as possible. Apply ice for 10-20 minutes at a time, at least 3 times a day for the first 48-72 hours. Utilizing a cold compression wrap numbs the nerve and reduces inflammation, greatly reducing pain.
To use a MendMeShop cold compression wrap, you simply pop the removable gel packs in the fridge or freezer for about an hour. (You can leave them there when you're not using them and the gel will never freeze solid.) When you're ready to use your wrap, remove the gel packs from the freezer, position them to target the specific area, and the stay-soft gel conforms to the unique curves of your ankle and stays there!
Blood Flow Stimulation Therapy
Once inflammation has subsided, an ankle Inferno Wrap™ is one of the most helpful tools for painful ankle related problems. With the Inferno Wrap™, tissues are safely and gently heated - increasing blood flow around the ankle. Your body's natural response to this increased temperature is to try to maintain a condition of homeostasis - a balanced environment or state of equilibrium throughout the body. To do this, your body responds with a rapid increase in blood flow to the area (vasodilation), increasing the supply of nutrients to injured cells and flushing out toxins to promote healing. Our ankle Inferno Wrap™ provides effective, non-invasive, non-addictive pain relief with no side effects.
Cold Compression Wraps will reduce initial inflammation and swelling and the Inferno Wrap™ circulates blood through the area to speed the healing process. This can be further helped by the use of ultrasound applications over the affected area, as it reduces swelling quickly and increases blood flow to the area.
The long term use of therapeutic ultrasound is common when treating tarsal tunnel syndrome. The application of MendMeShop ultrasound therapy will:
- Counteract atrophy in muscles and tendons.
- Increase the elasticity of all tendons that pass through the tarsal tunnel.
- Soften inelastic scar tissue from injured tendons / muscle fiber to the point where it is eventually re-absorbed by the body.
- Decrease inflammation of tendons, and the flexor retinaculum (a fibrous sheath passing through the tarsal tunnel). All tendons in the tarsal tunnel are sheathed, and once tendons become inflamed, the sheath swells and can also become inflamed, and at the worst, infected. If you suspect you have any type of infection in the area, please consult a physician immediately as this can be very damaging if left untreated.
You will notice therapeutic ultrasound starts to alleviate tarsal tunnel syndrome symptoms almost immediately, but to truly treat it properly and prevent reoccurrence, an extended treatment term is required - 2 months is not unusual. Treatment length will vary depending on the severity. There are some cases of tarsal tunnel syndrome that are just too chronic, in which case there are very few treatment options other than surgery. If this is the case for your tarsal tunnel syndrome condition, please make sure you are fully informed about the risks and rewards of corrective surgery.
Never use Ultrasound over anything area suspected of being infected.
Never use Ultrasound after surgery until your physician recommends and approves of it.
Do you have more questions?
If you have any questions regarding our therapeutic products and your treatment options, please contact a MendMeShop Advisor for assistance. You can be assured all your questions will be answered in a thorough and courteous manner by our trained staff.
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