Tarsal tunnel syndrome affects the tibial nerve or parts of its branches (Fantinio, 2014). Tarsal tunnel syndrome is one of the most common reasons for heel pain.
The tarsal tunnel is a fibrous osseous tunnel situated posteriorly and inferiorly to the medial malleolus; with the tendons of the flexors of the foot, posterior tibial tendon, flexor digitorum longus, flexor hallucis longus and the tibial neurovascular bundle running through it (Fantinio, 2014).
Injury occurs when adhesions develop between the posterior tibial nerve and the surrounding soft tissue around the inner ankle. Adhesions restrict movement of the nerve which causes adverse neural tension.
Pain, pins and needles and numbness may be felt to radiate down the inside and bottom of foot. Management should include cessation of aggravating activities, mobilisation of the adhesions and soft tissue restricting the nerves movement.
Fantino O., 2014, Role of ultrasound in posteromedial tarsal tunnel syndrome: 81 cases, Journal of Ultrasound, 17(2); pp: 99-112