Miscellaneus Injuries to the Foot and Ankle (Tarsal Tunnel Syndrome)

Compression to the distal tibial nerve trunk or its branches is also known as tarsal tunnel syndrome. The tarsal tunnel is an anatomical region located at the medial aspect of the ankle joint, limited by fibro-osseous structures enclosing tendons and neurovascular elements within. There are no clear data regarding epidemiological aspects of this entity, but it is known that this condition is more frequent in middle-aged active women. This syndrome commonly arises in the setting of several well-known progressive pathophysiologic changes described in chronic compressive neuropathies, and its clinical presentation is usually characterized by different grades of pain and/or sensory disturbances in the medial ankle, heel, plantar region, and plantar aspect of toes. Numerous external and internal etiological factors are responsible for tibial nerve compression in this location; in consequence, proper management should be oriented to treat the causative factor, being crucial to distinguish nerve compression from other pathologies which produce hindfoot pain.