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Tarsal Tunnel Syndrome/Posterior Tibial Nerve Entrapment, Sports Medicine

Stephen M. Simons, MD, FACSM and Jordan F. Geroski, DO Reviewed 04/2019
 


BASICS

DESCRIPTION

  • A compression neuropathy which causes pain and/or paresthesia along the medial ankle and plantar foot secondary to entrapment of the posterior tibial nerve or one of its branches as ...

DIAGNOSIS

HISTORY

  • Tarsal tunnel syndrome (TTS) presents with a nonspecific, highly variable clinical picture.

  • History of trauma or repetitive activity (e.g., running)

  • Numbness, tingling, and burning to t...

TREATMENT

GENERAL MEASURES

Conservative treatments are recommended prior to NCSs or surgical interventions 1[C]: 
  • Acute treatment:

    • Custom orthotics with arch support

    • Immobilizing braces

    • Muscular stretching...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Higher cutaneous pressure thresholds. Periodically repeating basic sensory testing throughout the treatment course allows for monitoring of the ...

REFERENCES

1
McSweeney SC, Cichero M. Tarsal tunnel syndrome—a narrative literature review. Foot (Edinb).  2015;25(4):244–250.
2
Pomeroy G, Wilton J, Anthony S. Entrapment neuropathy about the foot ...

ADDITIONAL READING

  • Reichert P, Zimmer K, Wnukiewicz W, et al. Results of surgical treatment of tarsal tunnel syndrome. Foot Ankle Surg.  2015;21(1):26–29.

  • Tu P. Heel pain: diagnosis and management...

CLINICAL PEARLS

  • TTS is often underdiagnosed due to low clinician suspicion.

  • Many cases of TTS can be managed conservatively with relative rest from exercise, biomechanical control, and anti-inflammator...

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