Your tarsal tunnel is a soft-tissue tunnel on the inside part of your ankle, similar to the carpal tunnel that's in your wrist. You suffer pain called tarsal tunnel syndrome when the tibial nerve that runs through this tunnel is compressed or has a neuropathy, meaning that it suffers damage. If you have this syndrome, you are likely to feel sharp, shooting pain on the inside portion of your ankle or along the bottom of your foot. The pain may extend to your toes. The pain is sometimes aching, cramping or burning as opposed to sharp. Exercises can help prevent or treat this syndrome, but if you have tarsal tunnel pain you need to consult a doctor.
Exercise Reduction
Your doctor may require you to cut back on exercise if you suffer tarsal tunnel pain. You are likely to be restricted to no or limited activity for up to four weeks if you do not require surgery. If you do require surgery, you may be restricted for up to three months. When you begin exercising again, range of motion exercises that improve flexibility of the gastrocnemius and soleus muscles in your calf and the plantar fascia in your foot come first. You must develop a specific program with your doctor or physical therapist.
Flexibility Exercises
Improving the flexibility and strength in your calf and foot area may help you avoid tarsal tunnel pain. Flexibility exercises include the gastrocnemius stretch in which you put one heel on the floor, step slightly forward with the other leg and stretch forwards. This may be performed leaning toward a wall that you rest your hands on. The soleus stretch is performed the same way, except your stretching leg is bent at the knee. Standing on a step and letting your heel drop is another exercise that improves calf flexibility. Perform a plantar fascia stretch by sitting with your left leg out straight and right leg bent with your left hand on your toes. Pull the bottom of your foot up and slightly to the left with your hand.
Strength Exercises
Strengthen your calf area with static toe flexion. With bare feet, press your toes into the floor but don't let them curl and don't let your ankle move. Also practice lifting each of your toes in turn and spreading your toes as much as you can. Then pick up a pen with your toes and hold it for six seconds. Walking on your heels and toes for up to 20 seconds at a time also will strengthen this area.
Considerations
Exercise alone may not be enough to prevent tarsal tunnel syndrome or keep it from returning after treatment. While this syndrome may be caused by trauma like a sprained ankle, tarsal tunnel syndrome is often simply an overuse injury. Overpronation of your foot is a common cause for tarsal tunnel syndrome because it causes increased tension on the tibial nerve. Supination of your foot is another possible cause because this compresses your tarsal tunnel. Thus, correcting your foot biomechanics is one of the primary aims of tarsal tunnel syndrome treatment and prevention. That's done with special shoe inserts called orthotics. Orthotics can correct your pronation issues or relieve nerve pressure by compensating for foot deformities.
References
- "Orthopedic Massage"; Whitney Lowe; 2009
- "Athletic Training and Sports Medicine"; American Academy of Orthopaedic Surgeons; 2006
- "The Foot and Ankle"; Alfred L. Logan, Lindsay J. Rowe; 1995
- SportsInjuryClinic.net: Stretching
- SportsInjuryClinic.net: Strengthening
- SportsInjuryClinic.net: Tarsal Tunnel Syndrome
