Rehabilitation for Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, also known as TTS or posterior tibial neuralgia, is a disorder of the foot that, despite being a relatively benign condition, results in significant pain. In many cases, the pain, burning, tingling and numbness resulting from tarsal tunnel syndrome can be successfully reduced and even eliminated by physical therapy. Sometimes, however, surgery is necessary.

Nonsurgical Rehabilitation for TTS

Before considering surgical intervention for tarsal tunnel syndrome, physical therapy is tried. Such therapy usually consists of two to three weekly therapy sessions for about 6 weeks, though the duration of treatment is determined by the prescribing physician. Following a thorough physical evaluation, a program of physical therapy is designed to meet the specific needs of the individual patient.

Physical therapy typically includes exercises to stretch and strengthen the muscles of the foot and ankle, application of heat or ice, massage, hydrotherapy and ultrasound therapy. A program of detailed exercises is also provided so the patient can reinforce treatment at home. At the end of the course of physical therapy, the therapist and the physician will reevaluate the patient's condition to assess whether more therapy is required or whether a surgical procedure is necessary.

Rehabilitation After TTS Surgery

When physical therapy is unsuccessful in relieving the pain associated with tarsal tunnel syndrome, surgery to relieve pressure on the tibial nerve may be performed. Immediately after this surgical procedure, the affected leg must be kept elevated and should not bear weight for at least 2 weeks. As a necessary part of postsurgical healing, physical rehabilitation is begun as soon as possible. During the weeks of rehabilitation, treatment may consist of a combination of some or all of the following:

  • Exercises to improve balance
  • Exercises to stretch and strengthen muscles and tendons
  • Hydrotherapy
  • Ultrasound
  • Massage
  • Application of ice or heat

Complete recovery from surgery for tarsal tunnel syndrome may take from 3 to 6 months, depending on the condition of the individual patient. In some cases, custom-made orthotics or ankle braces may be prescribed and manufactured to provide additional support.

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