What is Tarsal Tunnel Syndrome?

Tarsal Tunnel Syndrome is similar to Carpal Tunnel Syndrome. When the Posterior Tibial Nerve becomes compressed.

Tarsal tunnel syndrome involves a complex interplay of muscles, nerves, and tendons.

We will run through a quick overview of of the structures involved. Then we will explain the muscles we would treat to relieve your symptoms.

• Flexor Retinaculum: This is a tough band of tissue that forms the roof of the tarsal tunnel. It holds everything inside the tunnel in place. If this tissue becomes tight or inflamed, it can put pressure on the structures within the tunnel.
• Posterior Tibial Nerve: This is the main nerve affected in tarsal tunnel syndrome. It’s responsible for providing sensation to the bottom of the foot and controlling certain muscles in the foot. The nerve runs through the tarsal tunnel along with other structures.
• Posterior Tibial Nerve Branches: Within the tarsal tunnel, the posterior tibial nerve divides into smaller branches that supply different areas of the foot. When these branches get compressed or irritated, it can lead to the symptoms of tarsal tunnel syndrome, such as pain, tingling, and numbness.
• Tibialis Posterior Tendon: This tendon runs through the tarsal tunnel and helps to support the arch of the foot. It’s responsible for various foot movements, including pointing the foot downward and inward. Inflammation or swelling of this tendon can contribute to the compression of the nerves in the tarsal tunnel.
• Tibial Posterior Artery: Prolonged compression or constriction of the tibial posterior artery can lead to reduced blood flow to the tissues it supplies. This reduced blood flow, known as ischemia, can contribute to symptoms like pain, numbness, and tingling in the foot and ankle area. Impaired blood flow can hinder the body’s ability to heal damaged tissues, including the nerves.

How can Sports Massage help with Tarsal Tunnel Syndrome?

• Tibialis Posterior: Myofascial release techniques can help release tension in the tibialis posterior muscle, which can alleviate pressure on the posterior tibial nerve. It’s also important to release any of the muscles surrounding the Tibial Posterior Artery to restore adequate blood flow.
• Flexor Digitorum Longus: This muscle helps to flex the toes and can contribute to the overall tension in the foot. Releasing tension in this muscle can aid in reducing pain associated with Tarsal Tunnel Syndrome.
• Flexor Hallucis Longus: Similar to the flexor digitorum longus, this muscle contributes to toe movement. It is important to release tension in this muscle as well.
• Gastrocnemius and Soleus: These calf muscles are connected to the Achilles tendon, which can indirectly affect the tension and alignment of the foot and ankle. Addressing tension in the calf muscles has a positive impact on foot mechanics and pain relief.
• Plantar Fascia: While not directly involved, tension in the plantar fascia can affect the overall function of the foot. Think about how stretching and releasing the muscles and tendons in the hand will decrease pressure in the wrist. In much the same way releasing tension in this area can contribute to better mobility and less pain in the ankle and foot.

What might put someone at a higher risk of developing Tarsal Tunnel Syndrome?

• Running and Jogging: High-impact activities like running and jogging can put repetitive stress on the lower leg and feet, potentially leading to inflammation and nerve compression.
• Walking or Standing for Prolonged Periods: People who spend long hours on their feet, such as retail workers, healthcare professionals, and event staff, may be at a higher risk due to the prolonged pressure on muscles and nerves in the lower leg and feet.
• Dance: Activities that involve repetitive foot movements, such as dancing, especially on hard surfaces, can contribute to tarsal tunnel syndrome due to the extra stress on the foot and ankle.
• Cycling: Cyclists who wear shoes that are not properly fitted or who use pedals that don’t provide proper support might experience extra pressure on the “tarsal tunnel” (anterior ankle) area during pedaling.
• Soccer and Football: Sports that involve sudden changes in direction, quick stops, and starts can increase the risk of ankle injuries and subsequent nerve compression.
• High-Impact Aerobics: Aerobic exercises that involve jumping and landing on the feet can place strain on the foot and ankle structures, potentially leading to compression of the posterior tibial nerve.
• Weightlifting: Activities that involve heavy weightlifting and improper lifting techniques can put strain on the lower body, potentially affecting the alignment of the foot, knee and ankle. This can contribute to nerve compression.
• Yoga and Stretching: Certain yoga poses or stretches that involve extreme ankle flexion or extension can contribute to nerve compression if not performed with proper alignment and technique. These poses may also inform a person that they need soft tissue treatment to reduce nerve compression in these poses.
• Martial Arts: Activities that involve kicking or pivoting movements can increase the risk of ankle injuries and nerve compression within the tarsal tunnel.
• Footwear Choices: Wearing tight or poorly fitting shoes during any physical activity can increase the risk of developing tarsal tunnel syndrome. Wearing high heels, certain types of boots etc. Wearing barefoot shoes and walking barefoot as often as possible could reduce your risk of developing a number of issues including Tarsal Tunnel Syndrome

It’s important to note that while these activities may increase the risk, soft tissue therapy, proper footwear, technique, and conditioning can help reduce the likelihood of developing tarsal tunnel syndrome. Be sure to check with your physician and see if you are cleared for soft tissue therapy.

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