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Tarsal Tunnel Release

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What is tarsal tunnel release? 

Tarsal tunnel syndrome is a condition caused by repeated pressure that results in damage on the posterior tibial nerve. Your tibial nerve branches off of the sciatic nerve, located near your ankle. The tibial nerve runs through the tarsal tunnel, a narrow passageway inside your ankle that is bound by bone and soft tissue. Damage of the tibial nerve typically occurs when the nerve is compressed from constant pressure. 

Causes: Tarsal tunnel syndrome results from compression of the tibial nerve, and is can be instigated by other conditions. Causes can include:

  • severely flat feet
  • benign bony growths in the tarsal tunnel
  • varicose veins in the membrane surrounding the tibial nerve
  • inflammation from arthritis
  • lesions and masses like tumors or lipomas near the tibial nerve
  • injuries such as an ankle sprain or fracture — inflammation and swelling from which lead to tarsal tunnel syndrome
  • diabetes, which makes the nerve more vulnerable to compression 

Sign & Symptoms: People with tarsal tunnel syndrome may experience pain, numbness, or tingling. This pain can be felt anywhere along the tibial nerve, but it’s also common to feel pain in the sole of the foot or inside the ankle. This can feel like:

  • sharp, panging pains
  • pins and needles
  • an electric shock
  • a burning sensation

Symptoms vary greatly depending on the individual. Some symptoms progress gradually, while other symptoms can pop up out of nowhere. Pain and other symptoms are often aggravated by physical activity, but if the condition is long-standing, some people even experience pain or tingling at night or when resting. 

Diagnosis and Treatment: Tarsal tunnel syndrome should be identified and treated as soon as possible to prevent the condition from worsening. After inquiring about any histories of trauma to the affected area, medical professionals examine your foot and ankle to look for physical characteristics that could indicate tarsal tunnel syndrome. They’ll likely perform a Tinel’s test, which involves gently tapping the tibial nerve. Tingling sensations or pain as a result of that pressure indicates tarsal tunnel syndrome. Your doctor may also order additional tests such as electromyography, which is a test that can detect nerve dysfunction. MRIs may also be ordered if your doctor suspects that a mass or bony growth could be causing the tarsal tunnel syndrome.

In severe, long-term cases, your doctor may recommend a surgery called the tarsal tunnel release. This procedure involves the surgeon making an incision from behind the ankle down to the arch of the foot. They will release the ligament, relieving the nerve. A minimally invasive surgery is also used by some surgeons, in which much smaller incisions are made inside your ankle. Surgeon utilize tiny instruments to stretch out the ligament, creating the opportunity for reduced risk of complications and recovery time. 

Recovery: After the tarsal tunnel release, you will most likely be non-weight bearing for three weeks. After the splint is discontinued, you can begin gradual range or motion activities and return to weight bearing with possible use of a surgical shoe.

Dr. Ray Lopez

Minimally Invasive Bunion Surgery