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Ask Your Physical Therapist: Burning feet could be tarsal tunnel syndrome

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When it comes to numbness or burning on the bottom of your feet, this could happen for a few reasons. However, we are going to focus on a specific cause: tarsal tunnel syndrome.

The tarsal tunnel is a canal at the inside of your ankle that houses tendons (what connects muscle to bone) and your tibial nerve. If there is compression on the tibial nerve, then a number of irritating symptoms can arise, including burning, aching, sharp, shooting pain behind and around the inside of your ankle bone and bottom of your feet and sometimes the toes. This syndrome can be difficult to diagnose at times since it mimics other conditions of the foot and ankle.

Tarsal Tunnel Syndrome is much like carpal tunnel syndrome in the wrist, of which many more people have heard. There are many potential contributing factors to Tarsal Tunnel Syndrome, including flat feet with a heel that drops in toward the floor in weight-bearing, anatomic anomaly (meaning the space where your tibial nerve travels in too small), repetitive motion, and starting into an exercise program or activity too intense, too rapidly.

Tarsal Tunnel Syndrome can be resolved if it is diagnosed and treated properly. Ultrasound and soft tissue massage can be done to reduce muscle spasm and tightness in the calves and arch of the foot, which may reduce compression around the nerve. If the patient has poor foot alignment, custom orthotics and footwear specific to the patient’s particular foot type can be beneficial in reducing tension stress on the tibial nerve.

Nerve glides are also very helpful. Your physical therapist will place your leg, foot and ankle in specific positions to glide your tibial nerve. This ensures that the tibial nerve is gliding properly in the canal in which it sits and is not being entrapped by muscles or connective tissue in the vicinity.

As with any nerve injury, tarsal tunnel can be difficult to get rid of, especially if the patient has suffered with it for prolonged periods. The longer the nerves have been compressed, the more likely the condition will be harder to fix.

The moral of the story is: if you are experiencing these symptoms, don’t wait another day. Seek physical therapy treatment so you can be evaluated and get on the road to recovery before the symptoms become more chronic.

Feel free to email me if you have any questions regarding tarsal tunnel. I would be happy to explain this condition further or to discuss your symptoms with you. Please email me at

Physical therapist Steve Miller is the co-owner of Cardin and Miller Physical Therapy in Carlisle. His column appears twice monthly in the Sentinel Thrive Section.


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