Tarsal Tunnel Syndrome

Tarsal Tunnel Syndrome

John Miller Physiotherapist

Article by John Miller

Tarsal Tunnel Syndrome

What is Tarsal Tunnel Syndrome?

Tarsal Tunnel Syndrome (TTS) affects the foot, stemming from compression of the tibial nerve. This nerve, an extension of the sciatic nerve, travels down the thigh, extends across the shin’s inside, and branches into the foot. It’s vital for sensation and muscle movement in the foot.

Understanding Tarsal Tunnel Syndrome

TTS involves the compression of the tibial nerve’s end portion as it passes through the tarsal tunnel, located between the Achilles tendon and a bony bump on the ankle’s inner aspect. The nerve also runs under a thick connective tissue band, which can become a source of compression.

Causes of TTS

TTS can result from trauma, overuse of muscles and tendons, complications post-surgery, ankle sprains, and conditions like diabetes and rheumatoid arthritis. It’s crucial for people engaging in activities like marathons to be aware of this risk.

What are the Symptoms of Tarsal Tunnel Syndrome?

The primary symptom someone with tarsal tunnel syndrome experiences is pain. In particular, burning pain along the inner aspect of the ankle or into the bottom of the foot. The following symptoms may also occur:

  • Tingling or pins and needles along the inner aspect of the ankle and foot
  • Pain with extended periods of walking or standing
  • Burning sensation at night
  • Weakness in the muscles that bend the toes and fan them outwards

Diagnosis and Treatment

A physiotherapist or doctor can diagnose TTS. Physical tests and, occasionally, nerve conduction studies confirm the diagnosis. Treatment focuses on reducing pain and inflammation, advising on proper footwear, and strengthening muscles in the lower limb. Consistent treatment typically yields improvement within weeks.

Physiotherapy For Tarsal Tunnel Syndrome

Preventing Tarsal Tunnel Syndrome

Prevention strategies include wearing supportive footwear, managing swelling post-injury or surgery, and avoiding sudden increases in high-impact activities.

Benefits of Physiotherapy for Tarsal Tunnel Syndrome

Physiotherapy plays a critical role in the treatment and management of Tarsal Tunnel Syndrome (TTS), offering numerous benefits that facilitate a quicker and more effective recovery.

Accelerated Healing

Physiotherapy techniques, such as manual therapy and ultrasound, may significantly reduce inflammation and pain. These methods enhance blood flow to the affected area, speeding up the healing process.

Customised Exercise Programs

Physiotherapists design tailored exercise programs to strengthen the foot and lower leg muscles. These exercises improve flexibility, reduce stiffness, and prevent future occurrences of TTS.

Improved Mobility

Regular physiotherapy sessions help restore range of motion and mobility. This is particularly beneficial for patients who experience stiffness and reduced movement due to TTS.

Education and Prevention

Physiotherapists provide valuable education on foot biomechanics, proper footwear, and ergonomic adjustments. This knowledge is essential for preventing future episodes and managing symptoms effectively.

Pain Management

Physiotherapy offers non-invasive pain management techniques, reducing the need for medication. Techniques like TENS (Transcutaneous Electrical Nerve Stimulation) can provide immediate pain relief.

Other Treatment Options for Tarsal Tunnel Syndrome

Orthotic Devices

Custom orthotics can be prescribed to correct foot biomechanics and reduce pressure on the tibial nerve.

Lifestyle Modifications

Simple lifestyle changes, such as weight management and avoiding prolonged standing or walking, can alleviate symptoms and prevent exacerbation.

Nutritional Advice

A balanced diet rich in anti-inflammatory foods can support the body’s healing process and reduce inflammation.

Surgical Intervention

In severe cases, surgical intervention may be necessary to release the nerve. Surgery is usually considered when conservative treatments fail to provide relief.

Complementary Therapies

Acupuncture and massage therapy can complement physiotherapy, offering additional pain relief and promoting relaxation.

Conclusion: Embrace Comprehensive Care

Embracing a comprehensive approach that includes physiotherapy and other treatment options can significantly improve outcomes for individuals with Tarsal Tunnel Syndrome. Always consult a healthcare professional for personalised advice and treatment plans.

What to Do?

Seek your physiotherapist’s guidance for an accurate diagnosis and a tailored treatment plan.

Related Articles

  1. Foot Posture Exercises – This article will likely offer readers exercises to improve foot posture, which can be crucial for managing and preventing conditions like Tarsal Tunnel Syndrome by ensuring proper foot alignment and function.
  2. Pinched Nerve – This page would discuss the symptoms, causes, and treatments for a pinched nerve, which is relevant for understanding nerve compression issues like Tarsal Tunnel Syndrome, providing a broader perspective on nerve-related foot problems.
  3. Foot Pain – This article offers insights into various causes of foot pain, including Tarsal Tunnel Syndrome, and suggests possible treatments, helping readers understand the broader context of foot health.
  4. Plantar Fasciitis – Readers will learn about plantar fasciitis, a common condition related to foot pain, and discover how it can be effectively managed and treated, providing valuable information for those experiencing similar symptoms.
  5. Pes Planus – Flat Feet – This page discusses flat feet, their impact on foot health, and their potential connection to Tarsal Tunnel Syndrome, offering readers preventive and treatment strategies.
  6. Metatarsalgia – The article explains metatarsalgia, a condition that causes pain in the ball of the foot, potentially related to or confused with Tarsal Tunnel Syndrome, enriching readers’ understanding of foot pain sources.
  7. Morton’s Neuroma – Readers will explore the symptoms and treatments of Morton’s Neuroma, another foot condition that can be relevant for those interested in foot health and conditions like Tarsal Tunnel Syndrome.
  8. Tibialis Posterior Tendinopathy – This article provides information on tibialis posterior tendinopathy, a condition that affects the foot and can be related to or exacerbate Tarsal Tunnel Syndrome, offering insights into diagnosis and management.

Common Causes of Ankle Pain


Welcome to our detailed guide on the common causes of ankle pain. As physiotherapists, we understand how various conditions and injuries can lead to discomfort in your ankle. From sprains to degenerative diseases, this guide aims to provide clear insights for the general public on navigating these issues.

Physiotherapist treating middle-aged patient for ankle pain
Physio Care For Ankle Injuries

Sprained Ankles and Syndesmosis Injuries

Sprained ankles, including syndesmosis injuries, are among the most common issues we encounter. These injuries can range from mild ligament stretches to severe tears, impacting your mobility and quality of life. Understanding the specifics of each type is crucial for effective treatment and timely recovery.

Ankle Tendinopathies

Tendinopathies, such as those affecting the Achilles and tibialis posterior tendons, are common in active individuals. These conditions arise due to overuse or trauma, leading to pain and swelling in the affected area. Targeted physiotherapy can significantly aid in recovery and prevent future injuries.

Posterior Ankle Conditions

Conditions like posterior ankle impingement and retrocalcaneal bursitis can cause significant pain, especially during physical activities. Recognising these conditions early and starting appropriate treatment is vital for maintaining ankle health and functionality.

Ankle Arthritis

Arthritis in the ankle, often a result of wear and tear or injury, leads to joint pain and stiffness. Early intervention and proper management, including physiotherapy, are essential to slow its progression and manage symptoms effectively.

Biomechanical Conditions

Abnormal foot and ankle biomechanics can lead to various issues, from pain during weight-bearing to nerve compression. Understanding and treating these conditions are crucial for restoring normal function and preventing further complications.

Systemic Conditions That May Cause Ankle Pain

Systemic diseases such as rheumatoid arthritis can manifest as ankle pain. It's important to address these underlying conditions to effectively manage ankle symptoms.


Ankle pain can arise from a multitude of causes, each requiring a unique approach to treatment. If you're experiencing ankle discomfort, we recommend consulting a physiotherapist or doctor for a thorough evaluation. A personalised care plan can significantly improve your quality of life and mobility.

Related Articles

  1. Sprained Ankle Treatment & Recovery Guide - This article provides comprehensive information on managing pain and inflammation for a sprained ankle, including initial RICE steps and exercises for restoring mobility​​.
  2. Anterior Ankle Impingement: Causes, Treatments, Tips & Guide - Offers insights into the causes of anterior ankle impingement, its treatments, and practical tips for management​​.
  3. Posterior Ankle Impingement: Causes & Treatments - Explains the condition of posterior ankle impingement, its causes, and available treatment options​​.
  4. Tibialis Posterior Tendinopathy - Discusses the condition affecting the tibialis posterior tendon, symptoms, and implications for foot arch pain and ankle stability​​.
  5. Achilles Tendinopathy - Answers frequently asked questions about foot and ankle pain associated with Achilles tendinopathy and provides an overview of tendon injuries​​.
  6. How To Strap An Ankle - Guides on the correct techniques and types of tape for ankle strapping to prevent or manage ankle injuries​​.

Foot, Ankle & Heel Pain FAQs


Welcome to PhysioWorks' comprehensive FAQ page on Foot, Ankle, and Heel Pain. Our expert physiotherapists are here to guide you in managing and overcoming discomfort. We’ve organised the FAQs into categories, each with a brief overview and links to in-depth articles, making navigation and understanding easier for you.

physiotherapist treating a patient for foot pain
Physiotherapist Demonstrating Foot Pain Treatment To Patient

Foot Pain

Step into the various causes of foot pain and learn effective ways to relieve discomfort. Understand the impact of activities like barefoot running.

Ankle Injuries

Explore common ankle injuries and how to address them. From sprains to ligament damage, find out the best practices for care and prevention.

Heel Pain

Uncover the reasons behind heel pain and the effective treatments available. This section is particularly useful for understanding conditions like plantar fasciitis and heel spurs.

Achilles Pain

Find out how to manage and treat Achilles tendinopathy, a common concern for athletes and active individuals.

Shin Pain

Learn about shin splints, their causes, and how to alleviate this common issue, especially among runners.

Youth Injuries

Gain insights into youth leg injuries, including growing pains and heel issues in children.

Balance & Proprioception

Enhance your balance and proprioception with our professional advice and exercises.

Related Articles

  1. Sprained Ankle Treatment & Recovery Guide: Offers detailed advice on how to manage sprained ankles, including immediate recovery steps and physiotherapy treatments​​.
  2. Ankle Pain: Effective Management And Treatment Options: Discusses various conditions leading to ankle pain and outlines effective treatment strategies, highlighting the role of physiotherapy in pain reduction and mobility improvement​​.
  3. Plantar Fasciitis: Provides an overview of plantar fasciitis, including common causes, treatment options, and related conditions like peroneal tendinopathy and Achilles tendinopathy.
  4. Achilles Tendinopathy: Focuses on the causes of Achilles tendinopathy, its impact on heel pain, and a range of treatment and prevention strategies​​.
  5. Ankle Strapping: Complete Guide To Injury Prevention: Explains the benefits of ankle strapping as a preventative measure against injuries, with a focus on techniques and materials​​.
  6. Heel Pain: Explores various causes of heel pain, including tendon injuries, foot injuries, bone injuries, and systemic conditions, alongside recommended treatments​​.
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