Tarsal Tunnel Syndrome Rehabilitation

Most athletes will not require surgical treatment of this injury. The following guidelines are for information purposes only. We recommend seeking professional advice before starting any rehabilitation.

Aims of rehabilitation:

• Reduce pain and inflammation.
• Correct any biomechanical dysfunction such as over pronation.
• Stretching & Strengthening.
• Gradual return to full fitness.

Reducing pain and inflammation:

• Rest. This may mean complete rest, staying off the foot with the aid of crutches or it may mean simply modifying normal training activities. It really depends how severe the pain and injury is. Switching from running to swimming or cycling for a while may be sufficient.
• NSAID's (non steroidal anti inflammatory drugs) such as ibuprofen may help in reducing inflammation and pain.
• Always check with a doctor before taking any medication. Asthmatics should not take ibuprofen.

Correction of biomechanical dysfunction

• If the athlete over pronates or the foot rolls in when running or walking then this may aggravate the condition. If they were to rest and not correct any possible causes then the injury is likely to return when normal training resumes.
• For mild over pro nation a motion control shoe may be sufficient. These are running shoes which have a dual density midsole. The harder material on the inside of the sole helps prevent the foot from rolling in.
• For greater pronation control an orthotic device may be required. These can be purchased off the shelf from most chemists or more specifically made to measure by a sports injury therapists.

Stretching and strengthening:

• The muscles of the back of the lower leg and the foot require stretching. This is particularly important if dorsi flexion of the foot (pushing the foot and toes upwards) reproduces pain.
• Stretching can be done three times a day, and should be done on a regular basis for a period of weeks - not just days....click here for more on stretching.
• The small intrinsic muscles of the foot and the arch supporting muscles should be concentrated on....click here for more on strengthening.

When might surgery be required?

• Surgery may be indicated when the diagnosis is definite and the athlete has endured several months of problems and has not responded to the conservative treatment above.
• Diagnosis is firm when the following factors are present; foot pain and numbness, a positive Tinel's sign (tapping on the nerve produces pain) and electrodiagnoistic testing (for nerve injury) is positive.
• Following surgery symptoms may improve after 6 weeks, although complete recovery may take 6 months or more.