Tarsal Tunnel Syndrome

Triathlon Forum
1

I wanted to see if any of you had any experience with tarsal tunnel syndrome. i.e. - Pinching the nerve that runs along the inside of your ankle due to an inflammed(tendonitis) posterier tibialis tendon.

Any info on treatments that you have experimented with, how long it took to heal and anything else is much appreciated.

Thanks guys,

Blake

2

Sure, see it every week in practice. What do you want to know? Treatments are similar (but more difficult) to carpal tunnel syndrome (i.e. stop the pull, stress, pronation, etc. that is causing the posterior tibial nerve compression). Usually an NCV (nerve conduction velocity) is done to confirm, then often an MRI to rule out a space occupying lesion in the tarsal tunnel (i.e. large varicosity pushing on the nerve) that can be addressed. Often, a nerve block is performed as well for diagnostic/therapeutic purposes as well.

3

I had a sharp pain out of no where last week monday, at about the 19mi point of a long run. It dulled, but was still painful. I took about 5 days off of running and hit the pool with aqua jogging. I am riding as I normally would and things seem fine. I have run 2x for 30min at it has gone ok, just a little bit of tightness and I have tingling feeling(not pain) behind my ankle bone when sitting, walking, jogging and sometimes riding. Is tingling ok?

I have increased my arch support in my running and cycling shoes, hoping that it will work.

Thanks,

BB

4

Ah. Yeah, after a long run many people’s gait (mine sure does) gets pretty bad as we tire and the foot pronates a lot more, putting more stress on the medial ankle/PT tendon. The PT nerve runs right next to the tendon and is common to see a little “neuralgia” type issues with PT tendon irritation.

You did the right thing by decreasing a bit and increasing some arch support and should be fine. Chronic cases of tarsal tunnel syndrome are no fun to deal with for both patient and physician alike as they don’t respond very well to treatment and surgical decompression of the tarsal tunnel does very poorly compared with carpal tunnel.

5

Thanks for your help rroof…if anyone else has anything to add, please chime in.

Blake