tarsal tunnel syndrome
by Donna
During an examination by a nurse practitioner, a member of my family practice group, she knuckled my arch which caused instant severe pain. I have been later diagnosed with having Tarsal Tunnel Syndrome. Is it possible that her examination caused this syndrome? ANSWER Hi Donna, I doubt that knuckling your arch caused tarsal tunnel, particularly since the tarsal tunnel canal is more in the area just below the medial malleolus (the medial ankle bone) and not in your arch. There is always the possibility that the knuckling injured something directly in that area but I do not think it would be mistaken for tarsal tunnel. If you have tarsal tunnel syndrome, this is something that usually takes a while to develop, in many cases from the way you walk, particularly flat-footed. In a foot that flattens out too much (over pronates), that creates a jamming on the outside of the ankle and a stretching on the inside of the ankle. It is this stretching that puts pressure on the ligament over the nerves in the tarsal canal. This ligament then puts pressure on the nerves and you end up with the symptoms of tarsal tunnel. There are other situations that can cause tarsal tunnel, such as trauma itself to the tarsal canal or perhaps a growth of some sort that also puts pressure on the nerves as they pass through the canal and will give the neurological symptoms as well. You do not mention if you are still having severe pain where the foot was knuckled so I do not know if that warrants any discussion. Marc Mitnick DPM DISCLAIMER
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