Normal foot vs. Tarsal Tunnel Syndrom

Tarsal Tunnel Syndrome, often abbreviated to TTS, is defined as the compression of the posterior tibial nerve at the tarsal tunnel. The condition is similar to carpal tunnel, only the tarsal tunnel is located on the inside of your ankle. The tibial nerve branches off of the sciatic nerve and runs down behind the knee and calf, going behind and under the medial malleolus and through the tarsal tunnel, reaching all the way to the sole of the foot. Once at the foot, the posterior tibial nerve divides into two branches, the medial and lateral plantar nerves. The superficial branches of the medial and lateral plantar nerves divide yet again into proper plantar digital nerves, which innervate the toes. The tarsal tunnel is a fibro-osseous space located on the inner aspect of the ankle. It essentially acts as a passageway for tendons, nerves and vessels to travel between the back of the leg and the foot.

Symptoms: common symptoms of tarsal tunnel syndrome include pain, numbness and tingling at the inside of the ankle and/or the bottom of the foot. In some cases, the symptoms are isolated in one particular area and in others the symptoms are felt radiating to the calf, heel, or even to the toes.  

Causes: there are multiple factors that can cause the tibial nerve to become compressed. For example, prominent veins, a ganglion cyst (or other masses within the tarsal tunnel), local trauma and even inflammation from arthritis can all lead to tarsal tunnel syndrome. Additionally, having severely flat feet can produce strain and compression on the tibial nerve by causing it to stretch. 

Diagnosis: Electrodiagnostic evaluation can be essential in establishing the diagnostic certainty of Tarsal Tunnel Syndrome.  For any questions for additional information, you can contact California Sports & Rehab Center at (310)-652-6060 or visit our website at (EMG/NCS). We can accommodate your needs in one of our convenient locations in the Los Angeles and Orange County areas.