Tarsal Tunnel Syndrome Exercises to Relieve Foot Pain

Tarsal Tunnel Syndrome (TTS) is a condition that causes pain, numbness, and tingling on the inside of the foot due to compression of the tibial nerve. Various factors, including injury, overuse, or an underlying medical condition, can cause it. While TTS can be difficult to treat, exercise can help manage the symptoms and improve foot health. This article will outline ten exercises that can help relieve foot pain caused by TTS. These exercises shouldn’t replace medical advice and treatment from a qualified clinician. 

Foot Flexion (dorsiflexion and plantarflexion)

This exercise stretches and strengthens the muscles in the foot and ankle, which may aid in relieving discomfort. To perform the exercise, sit in a chair with your feet flat on the floor. Slowly lift your toes toward your shins, then lower them back down. Next, lift your heel off the floor, then lower it back down. Repeat these movements once or twice for 10-15 repetitions.

Ankle Circles 

Ankle circles help to improve ankle mobility and increase circulation to the foot. To perform the exercise, sit in a chair with your feet flat on the floor. Lift your right foot off the floor and make clockwise circles with your ankle 10-15 times, then switch direction. Repeat the exercise on your left foot.

Toe Taps

This exercise helps with neuromuscular recruitment, especially after an ankle injury. To perform the exercise, sit in a chair with your feet flat on the floor. Lift one foot off the floor and tap your toes on the floor 10 times, then switch to your left foot and repeat the exercise. If this causes pain in the affected foot, either do it gentler or not at all.

Heel Raises

Heel raises help to strengthen the calf muscles and improve gait stability, reducing unwanted forces which can cause pain. To perform the exercise, stand with your feet shoulder-width apart and raise onto your toes, then lower your heels back down to the floor. Repeat the movement for as many repetitions as you can. Do it twice daily if it’s not uncomfortable or painful.

Ankle Alphabet

The ankle alphabet exercise helps to improve ankle mobility and proprioception and increase circulation. According to Harvard University, ankle alphabet also help improves balance and reduce falls. To perform the exercise, sit in a chair with your feet flat on the floor. Lift one of your feet off the floor and use your ankle to write the letters of the alphabet in the air. Repeat the exercise on the other foot.

Resistance Band Exercise

This exercise helps strengthen the foot and ankle muscles. To do the exercise, sit in a chair with a resistance band wrapped around the ball of your foot. Pull the resistance band toward you, then use your foot to stretch the band in the opposite direction, then slowly release the tension. Repeat the movement as often as possible, then switch to your other foot. For variation, attach the band around the inside or outside of the foot, get your partner to hold it or attach it to an object away from the body and either move the foot in or out for ten repetitions.

Heel and Toe Walk 

Heel and toe walking can help strengthen the foot and ankle muscles, aid proprioception, and help reduce discomfort. To do this exercise, stand with your feet together and lift onto your toes, then take a step forward on your toes. Next, lower your heels to the ground and take a step forward on your heels. Repeat the movement as many times as you can.

Calf Stretch

The calf stretch helps to stretch and loosen the muscles in the calf and reduce strain on the structures in the foot and ankle. Perform this exercise by standing facing a wall and placing your hands on the wall. Step back with your right foot and press your heel into the ground. Hold the stretch for ten seconds, switch to your left foot and repeat the exercise. Do this two or three times.

Toe Stretch 

Toe stretches help stretch the plantar fascia and muscles on the bottom of the foot, making the foot more efficient during gait. To perform the exercise, sit in a chair with your feet flat on the floor. Lift your right foot off the floor and place your toes on the edge of a book or step, allowing your heel to hang off the edge. Gently press down on your toes, stretching the muscles in your foot. Hold the stretch for 10-15 seconds, change feet and do the same.

Seated Ankle Stretch 

The seated ankle stretch helps to stretch and loosen the muscles inside the ankle. Carry out this exercise by sitting in a chair with your feet flat on the floor. Lift one foot off the floor and cross your ankle over the opposite knee. Gently press down on the side of your foot, stretching the muscles in your ankle. Hold the stretch for a count of 10-15 seconds, then change to the other foot and repeat the exercise.

When performing these exercises, it’s essential to use proper technique and start slowly, gradually building up to more repetitions and sets as your foot strength improves. If you experience pain or discomfort while performing these exercises, stop immediately and consult your healthcare provider before continuing.

In addition to these exercises, other strategies for managing Tarsal Tunnel Syndrome include:

• Wearing comfortable and supportive shoes.
• Using orthotics or inserts to support your feet.
• Avoiding activities that put excessive strain on your feet.

Your healthcare provider may also recommend other treatments, such as physiotherapy or medications, depending on the severity of your symptoms.

Risk factors for Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a complex condition caused by various intrinsic and extrinsic factors. 

Extrinsic causes arise from external factors, such as poorly fitting shoes, trauma, or post-surgical scarring. Anatomic-biomechanical abnormalities, such as tarsal coalition, valgus or varus hindfoot, and systemic diseases, including diabetes and inflammatory arthropathies, can also increase the risk of developing tarsal tunnel syndrome. Additionally, generalized lower extremity oedema and arterial insufficiency can lead to nerve ischemia, contributing to posterior tibial nerve compression.

Intrinsic causes of tarsal tunnel syndrome include tendinopathy, tenosynovitis, perineural fibrosis, osteophytes, hypertrophic retinaculum, and space-occupying or mass-effect lesions. Enlarged or varicose veins, ganglion cysts, lipomas, neoplasms, and neuromas can contribute to posterior tibial nerve compression (Kiel and Kaiser, 2019).

Self-care tips for managing Tarsal Tunnel Syndrome

If you suffer from tarsal tunnel syndrome, it can be challenging to manage the pain and discomfort associated with it. However, several self-care tips can help you alleviate your symptoms and improve your quality of life.

1. Wear properly fitting shoes and avoid high heels or shoes with narrow toe boxes.
2. Use shoe inserts or custom orthotics to support the foot and relieve pressure on the nerve.
3. Perform stretching exercises to improve flexibility and reduce tension in the foot and ankle.
4. Consider massage therapy or other relaxation techniques, such as yoga or meditation, to reduce stress and tension in the body.
5. Maintain a healthy lifestyle by eating a well-balanced diet, staying hydrated, and exercising regularly.
6. Seek professional medical advice and treatment for tarsal tunnel syndrome, including physiotherapy, medication, or any other treatments your doctor recommends.

By following these self-care tips, you can effectively manage your tarsal tunnel syndrome and improve your quality of life. Always consult your healthcare provider before starting any new self-care regimen.

When to seek medical advice

If you are experiencing tarsal tunnel syndrome symptoms, seeking medical attention is essential. Left untreated, the condition can lead to long-term nerve damage and loss of function in the affected area. If you are experiencing persistent foot and ankle pain, numbness, or tingling sensations, scheduling an appointment with your healthcare provider is advised. Your clinician will perform a physical examination and diagnostic tests to determine the underlying cause of your symptoms and recommend an appropriate treatment plan.

In some cases, tarsal tunnel syndrome may require surgical intervention to relieve pressure on the nerve and restore normal function to the affected area. Your care provider can guide you on the best course of action. Early diagnosis and treatment are critical to effectively managing tarsal tunnel syndrome and preventing long-term complications. Do not hesitate to seek medical attention if you are experiencing symptoms of this condition.

Things to consider before exercising

1. Check with your healthcare provider: Before starting any new exercise routine, it’s essential to check with your healthcare provider, especially if you have a pre-existing medical condition or are currently experiencing tarsal tunnel syndrome symptoms. Your healthcare provider can advise whether these exercises are appropriate for your situation and how to perform them safely.
2. Start slowly: Gradually build up your exercise routine over time. This will allow your muscles to adjust to the new movements and help prevent injury.
3. Warm-up: Before starting the exercises, it’s important to warm up your muscles with some gentle movements or stretches. This will help improve circulation to the affected area and reduce the risk of injury.
4. Use proper technique: To get the most benefit from the exercises and avoid injury, it’s essential to use proper form. This means paying attention to your posture, controlling your movements, and avoiding any jerky or sudden movements.
5. Listen to your body: If you experience pain or discomfort while exercising, stop immediately and consult your healthcare provider. It’s essential to avoid pushing yourself too hard to avoid compounding the problem.
6. Stretch after the exercise: After completing the activities, take some time to stretch your muscles to help prevent soreness or stiffness. This can also help improve flexibility and range of motion in the affected area.

Final Thoughts

Tarsal tunnel syndrome can be a frustrating and painful condition. However, regular exercise can be an effective way to manage the symptoms and improve foot health. Incorporating these ten exercises into your daily routine can strengthen your foot and ankle muscles, reduce pain and discomfort, and improve your overall quality of life. Remember, your health is your wealth!

References 

1. Kiel, J. and Kaiser, K. (2019). Tarsal Tunnel Syndrome. [online] Nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK513273/.
2. Publishing, H.H. (2020). The. [online] Harvard Health. Available at: https://www.health.harvard.edu/staying-healthy/the-alphabet-exercise-for-foot-and-ankle-strength.