Tarsal tunnel syndrome causes numbness, tingling, burning and pain on the inside of your ankle or the bottom of your foot. Your tarsal tunnel is the narrow space on the side of your ankle near your ankle bones. Covered with a thick ligament, the tunnel protects arteries, veins, nerves and tendons. Tarsal tunnel syndrome is a compression of these nerves. One treatment method for tarsal tunnel syndrome is rehabilitation.
Physical Therapy
Upon receiving a diagnosis of tarsal tunnel syndrome, your doctor will provide you with treatment options. One option is attending physical therapy. Physical therapy will last about six weeks and you will participate in physical therapy two to three times per week. The exact duration of your therapy depends on the recommendation of your doctor. At the end of physical therapy, your doctor will reevaluate your condition. Physical therapy includes stretching exercises, strengthening exercises, massage, ultrasound therapy, hot or cold modalities and other modalities as prescribed by your doctor. A physical therapist may also provide you with a home exercise program.
Stretching
Stretching for physical therapy should be completed three times per day. Tarsal tunnel stretches focus on the foot and the muscles in the back of your lower leg. Stretching pays close attention to dorsiflexion of your foot -- pushing your toes and feet upwards. Prior to deciding on stretches, your physical therapist will apply gently pressure to your foot to test your flexibility. Your foot should be able to reach a 90-degree angle without having to force it. Your flexibility or lack of flexibility is an indication of the muscles that need to be stretched. Stretches may include gastrocnemius and soleus muscle stretches -- your calf muscles. You may also perform stretches by using an exercise step. Tarsal tunnel stretching also focuses on your plantar fascia -- the thick band of tissue that runs from your heels down to your toes -- along the bottom of your foot. Your plantar fascia may be stretched manually or by rolling a cylindrical object along the bottom of your foot.
Strengthening
Strengthening exercises are often used during tarsal tunnel rehabilitation. Strengthening exercises can help reduce pain and increase the function of your foot. Exercises should be performed at the discretion of a physical therapist. Complete exercises in three sets of 10 repetitions daily. Strengthening exercises for tarsal tunnel syndrome include toe flexion, toe spreads, toe lifting and pencil lifts -- using your toes to lift up and move a pencil. Walking on your heels and toes is also completed in therapy and serves as functional strengthening exercise.
Considerations
Physical therapy is not guaranteed to reduce the symptoms of tarsal tunnel syndrome. Resting, applying ice and using anti-inflammatory medications may also reduce symptoms. Your doctor may also recommend immobilization to all your nerves and surrounding tissue to heal. Injections can provide pain relief. The use of an ankle brace or orthotic devices can help reduce pressure on the foot and limit excessive motion. As a last resort, surgery can be used to release the nerve compression.
