The tarsal tunnel is a small passage just below the medial malleoli (the large bony bulge on the inside of the ankle).  The posterior tibial nerve and artery pass through the tarsal tunnel (as well as three muscles the tibalis posterior, flexor hallucis longus and flexor digitorum longus).  If these structures become impinged they can cause pain and variety of symptoms in the foot.  Impingement can occur due to:

• Inflammation
• Trauma
• Over pronation (rolling in of the foot)

Symptoms

• Burning pain located on the sole of the foot usually around the arch and heel and sometimes under the toes
• Night pain
• Swelling
• Pins and needles or numbness may be felt in the sole of the foot.
• Pain may be aggravated by running and sustained periods of standing
• Pain may be aggravated by everting the foot (rolling foot so sole of foot faces outwards)

What you can do

• Ice therapy applied to the area just below the medial malleolus

What we can do

• Perform special tests to confirm diagnosis
• Assessment and improvement of foot mechanics i.e. over pronation of the foot
• Give advice on orthotics
• Massage to stimulate healing and reduce inflammation of tendons within tarsal tunnel