What Subway Trains and Feet Have in Common

I remember the first time I rode in a subway. I was utterly fascinated by all the tunnels running underground and how intricate the maps and routes were. What was even more fascinating was how tight the spaces were through which the subway trains traveled. It seemed in the tightest of tunnels as if there were only a few inches left for error.  

Compare that to the “tunnel” in our ankles and feet through which multiple structures travel. This is the Tarsal Tunnel. The tarsus is a region in the hindfoot. On the inside of the ankle, next to the ankle bones, a tunnel is created as nerves, tendons, veins, and arteries pass underneath the flexor retinaculum, a thick ligament. This area is narrow and often tight. 

On top of this, there are a few things that can make this small space even smaller. Enlarged varicose veins, chronic pronation of the ankle and foot, flat feet, and ankle sprains can all cause extra pressure on the tibial nerve which runs through this tunnel. Over time, the nerve gets more irritated and swollen. This is known as Tarsal Tunnel Syndrome.

Tarsal Tunnel Syndrome feels similar to other nerve compression issues. You may experience tingling, shooting pain in the inner ankle or heel, and numbness in heel or ball of the foot. Symptoms can be constant but usually come and go, leaving you with periods of pain and periods of relief.  

A podiatrist will diagnose Tarsal Tunnel Syndrome by performing a thorough visual exam, taking a detailed history, and evaluating your gait. X-rays are taken and used to rule out other causes of your pain. In some cases, an MRI or nerve conduction study is needed to fully diagnose Tarsal Tunnel Syndrome. 

Treatment for Tarsal Tunnel Syndrome focuses mainly on addressing the cause. In addition, treatments such as RICE and laser therapy will be prescribed to reduce swelling and promote healing. Orthotics or braces may be prescribed to help control pronation. And your podiatrist may suggest injections to calm extreme nerve pain. Like Carpal Tunnel, a surgical release of the nerve could be needed. At the FAAWC, we always discuss all options to suit a patient’s personal and medical needs.

If you’ve been experiencing symptoms of Tarsal Tunnel Syndrome, call the FAAWC today for an appointment. Our knowledgeable Delaware, Ohio podiatrists can help diagnose your issues and put you on the path to healing and a continued active lifestyle. Call today! 740.363.4373  

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