Foot pain is often ignored until it starts affecting daily walking, standing, or work performance. One commonly overlooked cause of inner ankle and foot pain is Tarsal Tunnel Syndrome, a nerve compression condition that can significantly reduce mobility and quality of life. Many patients confuse it with general heel pain or plantar fasciitis, leading to delayed treatment.
The tarsal tunnel is a narrow space on the inner side of the ankle, and when the tibial nerve gets compressed in this region, it leads to symptoms like burning pain, tingling, and numbness in the foot. Without proper management, the condition may gradually worsen and affect walking ability and balance.
At ADPORC - Asia Digital Physiotherapy & Orthopedic Rehabilitation Center, we frequently manage such nerve-related conditions using advanced physiotherapy techniques. Under the guidance of Dr. Saddam Hossain, PT, early diagnosis and structured rehabilitation can help patients recover without the need for surgery in most cases.
What Is Tarsal Tunnel Syndrome?
Tarsal Tunnel Syndrome is a nerve compression disorder where the posterior tibial nerve is compressed inside the tarsal tunnel, located behind the medial malleolus (inner ankle).
It is similar to Carpal Tunnel Syndrome in the wrist but occurs in the foot. This compression disrupts normal nerve function, causing pain, tingling, or numbness in the sole of the foot.
Functionally, it affects walking, standing, and weight-bearing activities, especially during prolonged activity.
Anatomy
The tarsal tunnel is located on the inner side of the ankle.
Formed by:
- Flexor retinaculum (roof)
- Medial malleolus and surrounding bones (floor)
Contents:
- Posterior tibial nerve
- Tendons (Tibialis posterior, Flexor digitorum longus, Flexor hallucis longus)
- Blood vessels
Clinically important point: Any swelling or structural change in this confined space can compress the nerve.
Pathophysiology
Compression of the posterior tibial nerve leads to:
- Reduced nerve conduction
- Local ischemia
- Inflammation
Common mechanisms include mechanical pressure, repetitive stress, and structural abnormalities. Over time, untreated compression may lead to chronic nerve dysfunction.
Common Signs and Symptoms
- Burning pain on the inner side of the ankle
- Tingling sensation on the sole of the foot
- Numbness in the foot
- Pain that worsens while walking or standing
- Increased pain at night
- Pain radiating into the toes
- Muscle weakness
- Difficulty standing for long periods
- Discomfort while walking
Caution: If symptoms are ignored, nerve damage can become chronic and recovery may take longer.
Common Causes
- Flat feet (overpronation)
- Ankle injury or fracture
- Varicose veins around ankle
- Ganglion cyst or swelling
- Diabetes-related nerve sensitivity
- Prolonged standing (workers, shopkeepers)
- Improper footwear
- Obesity
- Repetitive stress
How Tarsal Tunnel Syndrome Is Diagnosed
Physical Examination:
- Tinel's sign over tarsal tunnel
- Foot posture assessment
- Gait analysis
Special Tests:
- Tinel's Test (Ankle)
- Kinoshita Test
- Triple Compression Stress Test
Investigations:
- Nerve conduction study (NCV)
- MRI or Ultrasound if structural cause suspected
Clinical diagnosis is usually sufficient in early cases.
Physiotherapy Treatment at ADPORC
At ADPORC, our physiotherapy approach for Tarsal Tunnel Syndrome is structured around the patient's assessment findings, pain stage, and functional goals.
Assessment
Treatment begins with a thorough biomechanical analysis, foot posture evaluation, and gait assessment to identify the root cause of nerve compression.
Pain Control
Advanced electrotherapy such as TENS and therapeutic ultrasound is used to reduce pain and inflammation around the tarsal tunnel.
Manual Therapy
- Soft tissue release around the ankle and foot
- Joint mobilization to improve movement
Exercise Therapy
- Nerve gliding exercises to restore tibial nerve mobility
- Foot and ankle strengthening exercises
Movement Correction
- Gait retraining to reduce abnormal loading
- Load management strategies for daily activities
Prevention
- Footwear advice and orthotic guidance
- Activity modification to prevent recurrence
Surgery (If Applicable)
Surgery is considered only if there is severe nerve compression with no improvement after structured physiotherapy. The procedure involves a tarsal tunnel release. Most cases improve without surgery if treated early and appropriately.
Condition Comparison (Clinically Important)
| Condition | Pain Location | Key Feature |
|---|---|---|
| Tarsal Tunnel Syndrome | Sole of the foot | Nerve compression |
| Plantar Fasciitis | Heel | Morning pain |
| Peripheral Neuropathy | Both feet | Symmetrical symptoms |
| Ankle Sprain | Ankle | Injury-related |
| Achilles Tendinopathy | Posterior heel | Tendon disorder |
Home Exercises You Can Try
Commonly recommended exercises:
-
Tibial Nerve Glide: Sit with your leg extended and gently move your ankle up and down in a controlled manner.
Benefit: Improves nerve mobility and reduces nerve compression symptoms. -
Calf Stretch: Stand facing a wall and stretch one leg backward while keeping the heel on the ground.
Benefit: Reduces tension around the ankle and improves flexibility. -
Foot Arch Strengthening (Towel Scrunch): Use your toes to pull or scrunch a towel placed on the floor.
Benefit: Strengthens intrinsic foot muscles and supports arch stability. -
Ankle Mobility Exercise: Slowly rotate your ankle in circular motions while seated or lying down.
Benefit: Enhances joint mobility and reduces stiffness. -
Heel Raise Exercise: Stand upright and slowly lift your heels off the ground, then lower down.
Benefit: Strengthens calf muscles and improves foot support during walking.
Perform 10–15 repetitions, twice daily, strictly under the guidance of a physiotherapist to avoid overuse or incorrect movement patterns.
When to See a Physiotherapist (Visit ADPORC)?
You should consult a physiotherapist if you experience:
- Persistent foot pain for more than 1–2 weeks
- Tingling or numbness in the foot
- Pain affecting walking or daily activities
- Night pain or worsening symptoms
Ignoring these signs can lead to long-term nerve complications.
Why Asia Digital Physiotherapy & Orthopedic Rehabilitation Center (ADPORC) Is a Trusted Physiotherapy Center in Dhaka
ADPORC focuses on evidence-based physiotherapy for musculoskeletal, neurological, and sports-related conditions.
- Expert Care by Dr. Saddam Hossain, PT
Years of experience treating musculoskeletal and neurological conditions through structured rehabilitation. - Condition-Specific Physiotherapy Programs
Each treatment plan is designed based on clinical assessment, pain stage, movement dysfunction, and functional goals. - Advanced Electrotherapy and Rehabilitation Equipment
Modern modalities are used only when clinically indicated, combined with manual therapy and corrective exercises. - One-on-One Supervised Sessions
Individual attention ensures correct technique, safe progression, and faster recovery. - Accessible Location in Jatrabari, Dhaka
Patients regularly visit ADPORC from Jatrabari, Dholaipar, Shonir Akhra, Doyagonj, Puran Dhaka, Keraniganj, Narayanganj, and surrounding areas.
If you are looking for reliable tarsal tunnel syndrome physiotherapy in Dhaka, ADPORC provides structured, goal-oriented rehabilitation trusted by local patients.
Book Your Appointment Today!
Do not let pain limit your daily life. Take the first step toward effective recovery with professional physiotherapy care. Visit ADPORC and see why patients from Jatrabari and surrounding areas including Dholaipar, Doyagonj, Shonir Akhra, Saydabad, Jurain, Hasnabad, Puran Dhaka, Keraniganj, and Narayanganj trust us as a reliable physiotherapy center in Jatrabari, Dhaka-1204.
- Location: 270/1 Dholaipar, South Jatrabari, Dhaka-1204
- Call: 01950-935236
- Website: adporc.com
Asia Digital Physiotherapy & Orthopedic Rehabilitation Center