Title: Early Effects of Foot Therapy and Correction of Foot Posture for Tarsal Tunnel Syndrome.
PNS ID: 111123-1, Published: 11/23/2011, Updated: 12/12/2011.
Author(s): Lawrence Zieske BA, Andrew Yee BS, Susan E. Mackinnon MD.
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO.
Abstract: This 48-year-old woman presented with a three- to four-year history of severe bilateral foot pain that was worse on her left compared to the right side. On examination, the patient had flattened arches and a positive scratch collapse test over the tarsal tunnel on both feet. No Tinel’s sign was present over the tarsal tunnel. Electrodiagnostic studies were suggestive of mild tarsal tunnel syndrome. Foot physical therapy was issued to treat this patient's symptoms of tarsal tunnel syndrome. This therapy emphasized correcting the positioning of the foot to relieve compression of the tibial nerve through the tarsal tunnel. Exercises included flexion of the foot intrinsic muscles, foot balance, and standing heel raises. After two months of therapy, this patient showed improvement in her symptoms with greater relief of pain on the left compared to the right side. The scratch collapse at the tarsal tunnel was negative on the left, however it was still positive on the right. The patient continues foot physical therapy for improvement of foot posture. This early report describes the use of foot physical therapy to improve the positioning of the foot for relief of symptoms from tarsal tunnel.