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Lost in the Tarsal Tunnel Syndrome

Posted by on Tuesday, April 10th, 2012

“Tarsal Tunnel Syndrome”–sounds kind of like the title of a disaster or horror movie, doesn’t it?

“We’ve got to get out of the Tarsal Tunnel before it collapses!”

“If we leave now, we’ll never find out what’s causing the Syndrome!”

Well, I didn’t say it was a good movie.

Actually, by now you may be much more interested in finding out how Tarsal Tunnel Syndrome (that’s a lot of t sounds!) relates to the much more familiar sounding Carpal Tunnel Syndrome. That’s an overuse nerve injury in the wrist commonly found in people who have been spending way too much time pounding away on a computer keyboard without proper wrist positioning. Tarsal tunnel is the same thing, except it’s a nerve injury in the ankle that’s causing the problem.

“Wait a minute, do you mean my ankles have been spending way too much time typing that novel they insist they’re writing?”

Yes! Well, probably not; ankles are generally terrible writers. But tarsal is undoubtedly related to carpal. Let’s find out all about it!

Where and what is my tarsal tunnel? The tarsal tunnel is a canal in your foot that is made of bone on one side, and tough fibrous tissue on the other. The posterior tibial nerve runs through this tunnel. Similarly (see, I said we were doing similars today), the median nerve, which runs from your spine to your finger tips, passes through the carpal tunnel.

How does it go oh so wrong? Tarsal tunnel syndrome, and its companion carpal tunnel syndrome, occurs when there is pressure on the nerve from the tissue side of the tunnel. The nerve is pinched.

A pinched nerve? That doesn’t sound good. What does it feel like? How do I know that I have tarsal tunnel syndrome? If you have numbness and tingling, or a pins and needles feeling on the bottom of your feet and toes, especially at night, that’s a big sign. You may also feel ankle weakness and find yourself lacking in coordination (no, I am not going to use tarsal tunnel syndrome as an excuse for my inability to skate).

However, tarsal tunnel syndrome is sometimes confused with plantar fasciitis or heel spurs. The best way to find out if you have tarsal tunnel syndrome is to see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) and get an accurate diagnosis.

Suppose I do have tarsal tunnel syndrome? How did I get it? As we said before, it’s an overuse injury. If you do an activity that involves a lot of repetitive motion affecting the ankle, then you’re a candidate for tarsal tunnel syndrome. If you’re saying to yourself, “What activity does that to an ankle?” and can’t come up with an answer, don’t feel bad–it’s a quirky, unusual injury, much less common than its wrist counterpart.The most typical candidate for tarsal tunnel syndrome is someone who stands on their feet for long periods at a time.

Some people have conditions that predispose them to tarsal tunnel, though, including obesity, pregnancy, diabetes, hyperthyroidism, arthritis, diabetes. Swelling from an ankle sprain can also put pressure on the tarsal tunnel, pinching the nerve.

What do I do if I have tarsal tunnel syndrome? Catching it early is key to recovery. The first steps towards relief from TTS (may I call you TTS, Tarsal Tunnel Syndrome? Thank you!) is to figure out the cause and work on modifying that–get off your feet, wear shoes or an ankle brace that can offer more support. Anti-inflammatories can also relieve the pain somewhat. Massage therapy also can help. If none of these relieve the pain, a cortisone shot is the next step.

If all of that doesn’t work, and there’s a danger of permanent nerve damage, a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) may decide that it’s time to perform a procedure called a tarsal tunnel release. This is a relatively short, simple procedure where a podiatric surgeon makes a small incision to open up the tarsal tunnel, taking pressure off the pinched posterior tibial nerve.

Like we said, TTS is not that common, so we hope you can avoid it. Like try to keep your toes from playing with your Xbox all night. If,  however, you do find yourself with TTS or any other foot issue, contact The Center for Podiatric Care and Sports Medicine to ask the questions that will help get you started. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine LaiDr. Nadia Levy, and Dr. Ryan Minara have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.

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