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Tarsal Tunnel - surgery? Recovery?
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After over a year of being treated for Plantar Fasciitis with no resolution I went to a new doctor who suspected my issue was nerve related. I never had classic PF symptoms - no morning pain, no heel pain - just pain in my arch and forefoot (both feet) and only when running and much less severe when cycling. I had an EMG last week which confirmed tarsal tunnel in both feet. It's been a long frustrated road for me dealing with my feet. I've been to 6 different doctors, already done 2 treatments that failed (Tenex and PRP), tons or exercises, stretching, and soft tissue work (ART, graston, massage, dry needling, etc...), was told I had a fibroma that would require surgery (based on an MRI pre-PRP) that might mean the end to my running, and now tarsal tunnel. I am glad that I didn't agree with the fibroma diagnosis and requested another MRI. The results from this recent MRI prompted my new doctor to suggest my issue wasn't PF but something else. The new MRI confirmed minor PF thickening but no fibroma. Anyway, I meet with a foot and ankle surgeon Monday. I wanted to see if anyone else has had surgery for tarsal tunnel and what your recovery experience was like, especially if you had this in both feet. The orthopedic who diagnosed me suggested my best option would probably be surgery to release the nerve and possible a minor release of the PF at the same time; however, he is not a foot and ankle specialist which is why I see the foot and ankle surgeon Monday. I'm still trying to hold out a bit of hope that I can recover from this in time to still do Ironman Boulder and Lake Tahoe. It's also possible that maybe there is another treatment besides surgery but I guess I'm trying to plan for the worst just in case so I'm mentally prepared. If anyone has any experiences to share, or if any foot and ankle doctors or podiatrists have any information to share, I would greatly appreciate it!

Thanks!
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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I had tarsal tunnel surgery in Dec 13. Had entrapment in several spots and had been dealing with it for over a year. I went to Dr. Donald Baxter (of Baxter's nerve entrapment) in Houston. Met with him on Monday where he examined the foot and took my history. Had surgery on Tuesday. Flew home on Wednesday. Started stationary bike as soon as the nerve block wore off (it hurt, but it was ok to start). Started swimming after I took the stitches out. Waited 6 weeks to slowly start running, and started very gingerly and progressed slowly, intentionally.

I have numbness where the incision is, which is fine. Had a little residual nerve pain while everything was healing. It feels very odd to walk barefoot. I can run without nerve issue.

It is the only fix I am aware of to end the pain, and in my experience, nerve pain sucks. Good luck!
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Re: Tarsal Tunnel - surgery? Recovery? [irongirlfl] [ In reply to ]
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Thanks for the information with your experience with the surgery. I have nerve entrapment on both feet - medial on right and lateral on left. I'm sure surgery will be my only option and meet with the surgeon this morning. It helps to hear someone else who has been through it. Your recovery period doesn't sound too bad at all. Although even if it is longer I'm okay with that just to run with pain in both feet again! I'm just glad to finally have a diagnosis confirmed by the EMG after a year of dealing with this.
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Re: Tarsal Tunnel - surgery? Recovery? [irongirlfl] [ In reply to ]
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My surgery is scheduled for next Thursday. I would've tried to do it this week but I have a business trip early next week so I scheduled it after. It sounds like your surgery has been pretty successful so far, so I'm crossing my fingers this finally allows me to run and ride pain free again!
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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little red wrote:
My surgery is scheduled for next Thursday. I would've tried to do it this week but I have a business trip early next week so I scheduled it after. It sounds like your surgery has been pretty successful so far, so I'm crossing my fingers this finally allows me to run and ride pain free again!


I've also had tarsal tunnel surgery on both my feet. The first was also done by Dr. Baxter in 2008 on my left foot. It was successful. Honestly, I don't remember a lot about that recovery. So it was pretty uneventful. Basically, I had just graduated from law school and was studying for the bar exam, so I had a different type of trauma to contend with. I remember one, not the other. Go figure.

Anyhow, I had surgery on my right foot in 2013. It was done by another surgeon, because my insurance had changed. So I was kind of upset, because I really like Dr. Baxter. This recovery I remember fairly well. First, I was on crutches for about six weeks. Then I had to wear a boot for about a month or so. After that I was able to run, swim, bike, etc. I started running low mileages. About a month into that, I had a set-back. I tore some scar tissue. That took like another two weeks to get better. During this time, I gained about 10lbs and lost fitness.

I am pain free now. I think both surgeries were really worth it. I do think my recovery from my left foot was easier because the surgeon was more experienced and I wasn't as active as I had just gotten back into long distance running.




My triathlon training blog
Last edited by: tejanatab: Feb 2, 15 18:09
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Re: Tarsal Tunnel - surgery? Recovery? [tejanatab] [ In reply to ]
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tejanatab wrote:
little red wrote:
My surgery is scheduled for next Thursday. I would've tried to do it this week but I have a business trip early next week so I scheduled it after. It sounds like your surgery has been pretty successful so far, so I'm crossing my fingers this finally allows me to run and ride pain free again!


I've also had tarsal tunnel surgery on both my feet. The first was also done by Dr. Baxter in 2008 on my left foot. It was successful. Honestly, I don't remember a lot about that recovery. So it was pretty uneventful. Basically, I had just graduated from law school and was studying for the bar exam, so I had a different type of trauma to contend with. I remember one, not the other. Go figure.

Anyhow, I had surgery on my right foot in 2013. It was done by another surgeon, because my insurance had changed. So I was kind of upset, because I really like Dr. Baxter. This recovery I remember fairly well. First, I was on crutches for about six weeks. Then I had to wear a boot for about a month or so. After that I was able to run, swim, bike, etc. I started running low mileages. About a month into that, I had a set-back. I tore some scar tissue. That took like another two weeks to get better. During this time, I gained about 10lbs and lost fitness.

I am pain free now. I think both surgeries were really worth it. I do think my recovery from my left foot was easier because the surgeon was more experienced and I wasn't as active as I had just gotten back into long distance running.

Thank you for sharing your experience! That is good to hear! I know from my research and from what my doctor said the results can be mixed. But as he stated, I have maybe a 70-80% chance of running pain free with the surgery but a 0% chance of running pain free without it. He also said athletes are more likely to have a higher success rate due to motivation and doing what's necessary to rehab and recover. I think the recovery may be a little tough having both feet done at the same time, but I'm not keen on going through the whole surgery and recovery twice. It is very helpful to hear from others who have been through it. In a few months time I hope I can say mine results are successful!
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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Just take your time, especially with both feet being done. And from my experience, one of the causalities was rolling my ankle, so make sure you are stable and stay off of uneven ground while you are healing. It may be a week or two before you are walking very easily... I won't lie, it hurt for a while to walk on it (mostly from pressure on the scar) but I did way more walking than I probably should have (kids, dogs, life in general) initially. But you are correct... you will never be pain free without trying the surgery. Good luck and keep us posted!
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Re: Tarsal Tunnel - surgery? Recovery? [irongirlfl] [ In reply to ]
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Were you able to be weight bearing at all after surgery? I believe my doctor said no weight bearing for 2 weeks, which will be more of a challenge since I'm having surgery on both feet. I have a business trip 11 days after surgery so I'm trying to figure out if I'll be able to walk or if I'll need a wheelchair to get around the airport and everything - I'm hoping I'll be able to hobble around with walking boots by then. I had achilles surgery way back in 1996 and was able to walk in a walking boot without crutches by 2 weeks so I'm hoping this is similar. It's a bad time for me to not be able to walk because we are in the process of selling our house and moving across the country (and have 4 high energy dogs)... but it's really never a good time to have to do something like this.
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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We have 3 large dogs too... I feel your (coming) pain. I was allowed to weight bear as soon as the nerve block wore off and/or I could tolerate. I was in a low walking boot for a while, then switched to an oversized sneaker. BUT I had one stable leg. Be cautious and baby it as much as possible. Especially if you're in danger of getting clobbered by dogs.
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Re: Tarsal Tunnel - surgery? Recovery? [irongirlfl] [ In reply to ]
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I'm amazed you were able to weight bear as early as when the nerve block wore off. Maybe because I had both feet done at the same time, but I'm 4 days post-surgery and can't put weight on my feet. Well, I can put minimal weight if I need to stand to reach something, but no way I could walk or anything. I'm getting really good at crawling and scooting around the house and just borrowed a wheelchair so I can finally get out of the house a bit. I don't think I could put enough weight on my feet to even spin really easy on a stationary bike yet. I have my follow up appointment with my surgeon next Monday and will be talking to him on the phone later today to see what I'm cleared to do beyond upper body and core exercises. My surgeon said my feet were really bad, especially my right foot. He described the right foot as under pressure. This is the incision on my left foot, the right foot incision is slightly longer. It looks ugly, but I'm optimistic that I'm on the road to recovery and this will finally get me back to cycling and running and I'm crossing my fingers that I can still do IM Boulder and Tahoe this season!


.
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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HOLY OW!

I'm trying to upload a pic here but failing lol, so:

https://picasaweb.google.com/102876376648005397763/NovFeb1314?authkey=Gv1sRgCLChv8nzwNyFeA#6013746949861240050


and

https://picasaweb.google.com/lh/photo/Y6aIePdAhVP_OaqUOWfZvsz5WhE-h5PU6VyiFoMzyew?feat=directlink


my scar is a whole lot more compact than yours. Nice stitch job though! I can see why yours is tougher to walk on... mine hurt, but at least I could hobble wit most of the pressure on my good foot. I wonder why he went all the way above the ankle bone...


How does it feel nerve-pain wise? I had some weird shooting pain that went up towards my ankle bone for a week or so, and then everything calmed down a lot. The numbness took a while to get used to, especially walking barefoot.


Hang in there. Keep reminding yourself it was take a shot at this or deal with that awful nerve pain for the rest of your life :-/




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Re: Tarsal Tunnel - surgery? Recovery? [irongirlfl] [ In reply to ]
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The only pain I have is from the incision, so that is good! No other pain. I didn't even realize until after having the surgery how much my feet would feet sore and numb just sitting around - I have none of that any more. Yeah, the incisions are longer than I expected but I'm sure that is because he said the entrapment was much worse than he expected. I guess he talked to me about all this after surgery but I was so out of it I don't remember. :) I'm looking forward to my follow up appointment Monday to get a time line for when I can start doing things again! Thanks for the pep talks!
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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How long were you non-weight bearing? I'm going on 2 weeks now where I have to keep it elevated. At first the Dr said to wiggle toes and move foot around to help pull the nerve back in to place, but then after my post op appt, he put me in a boot and said it had to be immobilized and elevated.

Thanks for any words of wisdom you can pass on!
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Re: Tarsal Tunnel - surgery? Recovery? [ATCAdashi] [ In reply to ]
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I was non-weight bearing for about 2 weeks. I had to use a wheelchair since I had surgery on both feet. Around 2 weeks I was able to start weight bearing, not walking yet, but I was able to use a knee walker and switch which leg I would use to push and gradually add more weight bearing each day until I was walking in the walking boots around 3 weeks - no more walker. By 4 weeks I was able to walk in running shoes. I took the boots off most of the time when I was sitting or laying down. I did a lot of flexing and extending my foot for gradual stretching and to help the nerves glide. The first week or 2 I would elevate my feet if I was laying on the sofa, but I didn't need to keep it elevated all the time. I'm happy to answer any questions that you have since I'm several weeks ahead of you. Feel free to reply or send me a PM! Good luck with your recovery!
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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Hello everyone. I am new to the forum as I was searching for Tarsal Tunnel and found this page. Back round on me: 39 years old, 17 years as a PE teacher and Varsity Baseball Coach. Throwing Batting PRactice and hitting fungo 5 months of the year daily. Was an avid runner, softball, volleyball and baseball player and workout daily. I have had foot issues for 2.5 years and the first doctor thought it was PF. After injections, Orthodics, Special shoes and that stupid boot you wear to bed I went to a new doctor. He tried similar stuff then gave me an EMG and said I have nerve compression or Tarsal Tunnel. I have my surgery on Wednesday Sept 30 2015.

Some questions:

My doctor said no weight bearing for a month? See most of you are 2 weeks? I wonder why the difference?

Did you use crutches or the KNEE SCOOTER? I might try the IWALK 2.0?

Was showering difficult?

Last my doctor recommended MLS Laser Therapy to help the healing process. Did anyone do this and did it help/work?

Thanks. I have never had any injury my entire life and am very nervous that I won't be my athletic self again.

Any help?
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Re: Tarsal Tunnel - surgery? Recovery? [thecaptain12] [ In reply to ]
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Since I had surgery on both feet I had to use a wheel chair for the first 2 weeks and then I was able to use a knee scooter. Again, since I had both feet done at the same time I would alternate which leg I used to push with on the knee scooter, but since I work from home I was able to stay off my feet a lot. It was closer to 3-4 weeks that I could walk and 4-5 weeks that I could walk in running shoes again. I took baths instead of showers since I could keep my feet out of the bath easily. It wsa easy to lower myself and push myself out of the bath but no way I could take a shower and keep both feet out of it. I've never heard of the MLS laser therapy you mention, so I can't speak to that. I did do a lot of PT starting at 6 weeks - mostly stretching and deep massage and graston - to loosen up the scar area and prevent scar tissue forming. I had my surgery in February and was able to race Ironman Boulder in early August, Ironman Tahoe last weekend, and I have a 50K trail race in about 4 weeks ... so it is possible to get back to your prior athletic self again. Just be patient with your recovery and rehab! Good luck!
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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Little Red -

Just reading the posts now as I have TTS in both feet and am considering surgery. Where did you get yours done if I may ask? Still good results this far out? I too was diagnosed with PF. It has been like walking on glass for 3 months. As soon as that cleared, the TSS (along with the shooting nerve pain) appeared. Any recommendations going in for the surgery? Any info helpful. Im not going to make it to IM Choo this year with this stuff, but hope to be back to SBR soon! Thanks in advance for any advice.
Last edited by: Haweshouse: Apr 23, 16 10:41
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Re: Tarsal Tunnel - surgery? Recovery? [Haweshouse] [ In reply to ]
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I was living in Atlanta when I had surgery and Dr. Errol Bailey did my surgery. I moved to Salt Lake City about 6 weeks after surgery so did all my post-surgery rehab here. A lot of stretching and painful ART and graston to break up scar tissue and regain flexibility, and a lot of Alter-G running. Difficult because it was really up and down for several months. Nerves heal very slowly so you have to be patient. That said, just over 1 year out I am very glad I had the surgery. I had surgery last Feb and since then I've been able to do IM Boulder and IM Tahoe, several short trail races, and 4 50K trail races. It has been so nice to NOT have feet issues that I've been mostly focusing on trail running and ultras and am currently training for my first 50 miler. I've been able to consistently run 50-70 miles/week since starting my ultra focus, which I couldn't imagine doing this before my surgery. My advise going into surgery is find a surgeon who has experience with this surgery and be prepared to be patient during your recovery. I'm assuming you've had EMG and nerve conduction tests to confirm TTS?
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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Happy to find this forum. I have also been diagnosed with bilateral TTS, which I have been suffering with for 2 years and I was told was Tendonitis.I had orthodics, physical therapy, PRP injection. Finally was sent to a neurologist to get a Nerve Conduction test and confirmed
severe TTS. I need to have surgery on both feet and I am wondering if you guys went to an orthopedic surgeon or microsurgeon? Do your recommend doing both feet at once? Also, does the surgery involve local or general anestedic?


How was the recovery?


Thanks!
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Re: Tarsal Tunnel - surgery? Recovery? [kkhamblin] [ In reply to ]
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I had surgery on both feet at the same time. I work from home so not being mobile for a while wasn't a huge deal for me. I even worked the afternoon of my surgery. Personally, if I had to do it all again I would still do both feet at the same time. While it made life difficult for a while, at least I only had one recovery period versus 2, and was back training twice as fast as if I split it into 2 surgeries. My surgeon was an orthopedic foot and ankle specialist. You really want a surgeon who has experience with this surgery so find the best specialist you can. You will be under general, it is a pretty involved surgery. Recovery has a lot of ups and downs. Nerves are extremely slow to heal, so be prepared for some frustration along the road to recovery. I think I've detailed in prior posts my timeframe for getting back in the pool, cycling, running, and racing so won't go into those details again. Good luck!
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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Little Red - Thanks so much for your response. Very helpful. It sounds like you are back to doing all your events now, would you say the surgeries fixed the problem?

I am meeting with an Orthopedic Surgeon in a few weeks, unfortunately he is in high demand here in San Francisco so appointments are hard. I am also afraid I have compression in multiple places due to my symptoms. They alternate between pain in the ankle joints and numbness in the arch and lower leg. I am at the point where the only physical activity I can do is pulling in the pool without kicking.

Another question I had was on your Nerve Conduction Study. Not sure if you remember, but was your Tarsal Tunnel classified as mild, moderate or severe? Mine is considered severe. I am concerned because I have had such bad symptoms for almost 2 years that is can cause permanent nerve damage? Have your heard of this?

Thanks!
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Re: Tarsal Tunnel - surgery? Recovery? [kkhamblin] [ In reply to ]
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My tarsal tunnel was classified as severe on my right foot and moderate on the left. I was probably similar to you in that I had issues with my feet for a couple years but kept being told it was plantar fasciitis. My surgeon had to go really high up to release the nerves so my scars go up pretty high and wrap under my foot. I don't have any nerve related issues any more - no more forefoot pain, numbness, or burning. Nerves heal really slow (I think it's something like 1 mm per day) so I'm sure the more severe the compression the longer the recovery might take. It took probably 6 months for me to feel like my feet were recovered, but yes, I do think the surgery fixed the issue. It wasn't fun and the recovery was frustrating at times, but I think it was worth it.
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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Hi all! I've been suffering with this too in both feet for 4 months or so. Doctor is recommending release. I believe the use of orthotics in my last race brought it on. And ever since I can't tolerante any orthotics! I guess my question is, for those that have recovered from surgery, do you have flat feet? If so are you wesring orthotics now? Want to schedule this surgery for sooner than later so I don't fall too behind out of shape and also can't deal with the pain anymore in daily life (kids, work, etc). Any feedback would be greatly appreciated!
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Re: Tarsal Tunnel - surgery? Recovery? [Andy1978] [ In reply to ]
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I have pretty flat feet and I do not, and did not prior to surgery, use orthotics. I'm a believer is strengthening the feet to work as they should and work on correcting/preventing muscle imbalances and not using orthotics. I'm not saying they may work/help some people, but I'm just not a believer in them. I'm not really clear how wearing orthotics for a race would cause nerve entrapment? This isn't a sudden acute issue that would occur after just one race or run. It seems if the orthotics are hurting your feet then stop wearing them. My biggest advise to be to sure this is the correct diagnosis and make sure your surgeon has experience with this surgery because it isn't a simplest very common procedure.
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Re: Tarsal Tunnel - surgery? Recovery? [little red] [ In reply to ]
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Thank so much Little Red! I'm encouraged by your recovery & I appreciate your posts. My podiatrist believes the orthotics caused medial nerve entrapment from pushing into my arches. He also does believe that I would have eventually had tarsal tunnel anyway though (that both are related). The problem is of course that PT, podiatrists and orthotists all seem to say that orthotics is the only way to "cure" my tarsal tunnel but all the orthotics seem to do is irritate it even more. So obviously I have stopped trying to wear them. My podiatrist also believes that will scar tissue nothing will really work at this point but a tarsal tunnel release. He is also confident that there are other entrapments in the branches. I'm very nervous about scheduling surgery but look forward to waking up in the morning without nerve pain. Just praying my surgeries are as successful as yours were!
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