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Treatment for Tarsal Tunnel Syndrome in Zaragoza
At FisioSentis we tackle Tarsal Tunnel Syndrome in Zaragoza with physiotherapy treatment. Book your appointment now!
Do you feel persistent tingling or pain in the sole of your foot or heel that gets worse when you walk or stand for a long time?
You may be experiencing Tarsal Tunnel Syndrome (TTS), a lesser-known but relevant condition in physiotherapy. It’s a compressive neuropathy similar to the well-known carpal tunnel, but located in the ankle. In this article we explain, from a physiotherapy perspective, what it is, how it’s diagnosed, its treatments and how to prevent it to improve your quality of life.
What is Tarsal Tunnel Syndrome?
Tarsal Tunnel Syndrome is a condition caused by compression of the posterior tibial nerve as it passes through the osteofibrous canal located on the inner side of the ankle, just below the medial malleolus. This canal is bordered by the ankle bone and the flexor retinaculum.
Compression of this nerve can produce painful symptoms and sensory changes in the sole of the foot, the toes and the heel, affecting gait and the patient’s function.
Why does Tarsal Tunnel Syndrome happen?
The most common causes of TTS from a physiotherapy point of view include:
Biomechanical overload: especially in people with flat feet or excessive pronation.
Trauma: ankle sprains, fractures or direct impacts.
Compression by structures: such as ganglions, cysts, lipomas, varicose veins or muscle hypertrophy.
Chronic inflammation: from plantar fasciitis, posterior tibialis tendinitis or synovitis.
Postural alterations that increase pressure on the nerve.
It can also be seen in athletes, runners or people who spend many hours on their feet.
Symptoms and diagnosis of Tarsal Tunnel Syndrome
Common symptoms
- Pain or burning in the arch of the foot, heel or sole.
- Tingling or a cramping sensation in the toes.
- Worsening with prolonged standing or walking.
- Relief with rest or elevating the foot.
- Possible muscle weakness in advanced cases.
Physiotherapy diagnosis
At FisioSentis we carry out:
- A detailed clinical interview.
- Physical examination: sensitivity, joint mobility, muscle tone.
- Specific orthopaedic tests: Tinel’s test over the posterior tibial nerve, dorsiflexion-eversion test.
- Assessment of the footprint and gait.
In doubtful cases, the patient may be referred for confirmation via EMG, MRI or ultrasound.
Treatment from physiotherapy
Treatment goals
- Reduce inflammation and pressure on the nerve.
- Correct muscular or biomechanical imbalances.
- Restore the function of the foot and gait.
Therapeutic approach
- Manual therapy: joint mobilisations of the ankle and foot, myofascial release techniques.
- Tibial nerve neurodynamics: specific mobilisations to reduce neural irritation.
- Anti-inflammatory electrotherapy (TENS, ultrasound).
- Therapeutic exercise: strengthening the posterior tibialis, plantar arch stabilisers, ankle mobility.
- Stretching of the posterior leg muscles (calves, soleus, flexors).
- Neuromuscular or functional taping to offload structures.
- Postural education and gait correction with insoles if necessary.
Benefits of physiotherapy treatment
- Reduced pain and inflammation without medication.
- Improved footprint and gait pattern.
- Avoids invasive or surgical treatments.
- Progressive recovery of mobility and function.
- Prevention of future relapses through active education.
Recommended exercises
All these exercises should be prescribed and reviewed by a qualified physiotherapist.
Calf stretch against a wall
Place both feet facing the wall. The foot to be stretched goes back, heel on the floor, knee straight. Lean forward keeping the heel down.
Tibial nerve mobilisation
Seated with one leg extended, slowly move the ankle into dorsiflexion while extending the knee and flexing the neck.
Posterior tibialis strengthening
With a resistance band, perform foot inversion against resistance.
Plantar arch activation
Seated, try to “shorten” the foot without moving the toes (the short-foot exercise).
Tips and prevention for Tarsal Tunnel Syndrome
- Avoid tight or very flat footwear.
- Use custom insoles if you have flat feet or pronation.
- Take breaks if you’re standing for a long time.
- Stretch the posterior chain regularly.
- Manage the load in sports training.
- Improve your running technique if you’re an athlete.
Frequently asked questions about Tarsal Tunnel Syndrome
How long does it take to heal?
It depends on the degree of compression and how long it’s been present. With appropriate physiotherapy treatment, improvement usually begins in 3-6 weeks.
Is surgery necessary?
Most cases resolve with physiotherapy. Only severe, persistent, resistant cases may require surgery.
Can I walk or run with this syndrome?
It depends on the stage of the injury. A physiotherapist will tell you when to resume activity.
Can the pain go away on its own?
In the early stages it may ease, but if the biomechanical cause isn’t corrected, there’s a risk of it becoming chronic.
Tarsal Tunnel Syndrome can greatly limit daily life if it isn’t treated properly. Physiotherapy offers a complete, safe and effective approach to relieve the symptoms, correct the cause and avoid relapses. If you suspect this condition, a physiotherapy assessment is the first step towards recovery. If you think you may have it, don’t hesitate to book an appointment at FisioSentis.
