Your foot contains 26 bones, 33 joints, 112 ligaments and a network of tendons, nerves and blood vessels required for proper running technique. Because of the complex nature of your foot, injury may occur from time to time. As a runner, you may experience tarsal pain -- mid-foot pain -- on the right side of your foot. This condition is known as tarsal tunnel syndrome.
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is a condition of the foot marked by compression of the posterior tibial nerve, causing symptoms on the inside of your foot running toward the ankle. The tarsal tunnel is a narrow space on the inside of the ankle near the ankle bone. The tunnel is covered by the flexor retinaculum -- a thick band of ligament -- that helps protect the inside structures of your foot, including tendons, nerves, veins, arteries and your posterior tibial nerve.
Symptoms
If you have tarsal tunnel syndrome, you may experience pain, tingling, burning and numbness on the inside of your ankle as well as on the bottom of your foot. In some people, pain may extend into the heels, toes, calf muscles and the arch of the foot. Symptoms may come on gradually or be aggravated by overuse, increasing your training regime or beginning a new training regime.The symptoms of tarsal tunnel syndrome are often worse while running and tend to subside with rest.
Diagnosis
If you experience signs and symptoms of tarsal tunnel syndrome, consult a podiatric physician. A physical examination can help a doctor determine problems with the nerves of your foot. An X-ray may be taken to rule out other conditions. Your doctor may also order advanced imaging studies such as an electromyography and a nerve conduction study -- EMG/NCV -- to help test the function of your nerves. An EMG/NCV is often ordered if a patient shows no signs of improvement with conservative treatment for tarsal tunnel syndrome.
Treatment
Tarsal tunnel syndrome treatment is often conservative. Your doctor may recommend rest -- simply staying away from running or cross training. Cross training may include swimming, cycling or using an elliptical machine. Cross training activities can help maintain your strength and endurance for running. Treatment may also include ice, anti-inflammatory medications, physical therapy, injections, bracing, and the use of orthotic devices. Surgery is a last resort and is rarely required, but is an option if conservative treatment fails.
