When is physiotherapy recommended for tarsal tunnel syndrome?

Tarsal tunnel syndrome involves irritation or compression of the posterior tibial nerve near the inside of the ankle. It can cause burning, tingling, altered sensation, or pain in the ankle or sole. A clinician should assess the cause because swelling, foot mechanics, injury, or another nerve problem may require a different approach.

A physiotherapist may examine ankle mobility, calf flexibility, foot control, walking pattern, and sensitivity to nerve movement. Treatment aims to reduce aggravating load and improve function; it should not reproduce strong or spreading nerve symptoms.

Your plan may include changes to footwear and activity, calf or ankle mobility, foot and lower-limb strengthening, balance work, and carefully selected nerve-movement exercises. The therapist can also help you modify standing, walking, or exercise tasks that increase pressure around the ankle.

Use symptoms as feedback rather than pushing through tingling. Avoid suddenly increasing walking, hills, jumping, or prolonged standing if these worsen the foot. Keep review appointments so strength, sensation, and function can be checked as the programme progresses.

Arrange prompt medical review for increasing numbness, new weakness, frequent tripping, loss of foot control, or symptoms that continue despite reducing aggravating activity. Urgent care is appropriate for sudden severe weakness, a cold or discoloured foot, or severe pain after an injury.

Ask what is irritating the nerve, whether another condition needs excluding, which exercises are suitable, and how to respond if tingling spreads. Ask when imaging, nerve testing, or a specialist review would be considered.