What to expect from physiotherapy for tarsal tunnel syndrome

Tarsal tunnel syndrome involves irritation or compression of the posterior tibial nerve near the inside of the ankle. Your therapist may check sensation, ankle and foot movement, calf flexibility, muscle control, footwear and the way you walk. They may also look for activities or positions that increase tingling, burning or numbness. Treatment is tailored because symptoms can arise from more than one contributing factor.

You may practise calf and foot strengthening, balance, ankle mobility and controlled nerve-gliding movements. The therapist may suggest changing footwear, reducing prolonged standing, or modifying running and jumping while symptoms are irritable. Nerve exercises should be gentle and should not reproduce strong or lasting tingling. Build activity gradually, checking how the foot feels later that day and the following morning.

Seek prompt care for rapidly increasing numbness, new foot weakness, repeated tripping, loss of balance, or an inability to lift or control the foot. Sudden severe swelling, a cold or discoloured foot, or symptoms after a significant injury also need urgent assessment. Tell your clinician if numbness persists or progresses despite treatment, since nerve compression may need further investigation.

Ask what may be compressing the nerve, which footwear and activities are suitable, how to perform nerve glides, and when nerve testing or another treatment should be considered.