Exercises for Tarsal Tunnel Syndrome
by Marc Mitnick DPM
Today we're going to show you some stretches and exercises for tarsal tunnel syndrome. So let's get started. So the tarsal tunnel is on the inside, the medial side, of your foot, and it runs right behind and underneath that bump, which is your malleolus, and that little tunnel gets really irritated and tender, and sometimes you can have numbness in your foot if that area is getting compressed, so a great way to work it out is start off with just some range of motion exercises, so I like to prop up my foot just with thick towel.
If you are on a couch or bed as long as you're just propping it off the edge that's fine, you just want to have that room so your heel doesn't touch the floor so you have that movement in your ankle, so the first thing that we're just going to do is just a really simple ankle pump, and so the ankle pumps you just push down as far as you can, and then pull up as far as you can, so you're really just trying to get that whole area moving a little bit, so just starting off with 10 to 15 of those, just really kind of getting that movement in there and so that helps just kind of loosen everything up. So after you do an ankle pump, then you're gonna do ankle circles, so now just making a circle with your ankle.
Now the big thing to remember with the ankle circles is to really try and do it just at your ankle, so it's not making a circle with the whole leg, your leg is pretty much staying in one spot, and then you're doing those circles, so do ten one way and then reverse it and do ten the other way. So again this is just loosening up that ankle, loosening up that tendon getting some motion just to kind of get some flow in there and increase the circulation in there.
So after the circles, then you're going to do a side to side, or we call them windshield wipers, so this time it's going to be out back and forth, so again with this one, it's not the whole leg going back and forth, it's really just at your ankle, so if you have to put your hand on your leg to make sure it's not moving, that's fine, but again just ten of these just to make sure that that whole area is getting loosened up before you start doing stuff.
So after you do all those, then we're going to go into a calf stretch. For the calf stretch using a strap, or if you don't have a strap you can use a belt or you can use a dog leash, something that has the loop usually works a little bit better because then you can just put it around your foot just about at the ball of your foot, not too high not too low because you're gonna use the strap to get this stretch. So you're not actively moving your foot towards you, you're taking that strap and pulling the top of the foot towards you, so you should feel the stretch in the calf area there and since this is a stretch you want to hold it for 30 seconds, so after the 30 seconds relax it, shake it out a little bit, and then do that a total of three times, but getting a nice good stretch in there it shouldn't be painful, so if it's a little bit painful on that medial side, take off that pressure just a little bit. If you want to get that medial side stretched a little bit more, you can kind of turn your foot outwards just a little bit and stretch, and that'll stretch that inside just a little bit more, not a whole lot more, but just a little bit more of that in that tunnel area.
So after you do that three times, thirty seconds, then you're gonna do a ball roll. So I'm gonna grab a ball. You can use a lacrosse ball, you can use a tennis ball, you can use the racket ball ,but you want it to be slightly firm because that's going to just kind of work that whole area of the foot, the bottom of the foot area there, so you can do this sitting in a chair, you can do it sitting down on the floor for a little bit less pressure, but just put it under the arch of your foot, and just roll it around a little bit. So since all those tendons that go through that tarsal tunnel go kind of down into the foot, you really want that area to be loosened up as well, so just rolling the foot around on the ball, you can kind of even go into the heel a little bit does a good job of just kind of loosening up that fascia, loosening out those tendons around around the foot and the ball of the foot area.
So you can just do this for about a minute to three minutes if you want to, if it feels good it's a great way to you do something at work because if you're sitting at your desk, you can just put the ball down on the ground and then roll it out that way, so that's that's a really nice way to do it as well. Then what you want to do is what we call a cross friction massage just right on that tunnel area, so get this area right here that goes behind that bump that malleolus is the tunnel on the inside. So cross friction massage is basically if the tendon is going this way downwards and through, you want to cross it so you're instead of doing the massage up and down, you're doing it a side-to-side, so this is designed to really kind of get that blood circulation to the area, so you want to push pretty firmly up and down, but you don't want to be painful, a little bit sore, a little bit uncomfortable is okay, but you're really trying to get that friction in there just to help give that circulation to that tendon or those tendons that go through that tunnel, and all those vessels that go through the tunnel, so just working your way up and down.
You only have to do this about a minute, if the area gets a little bit red, that's okay, that's just bringing the blood to the surface that means it's working, but again you don't want it to be painful while you're doing it, but you're you're crossing that tendon you're doing that cross friction massage. So now I'm going to show you some exercises standing up. So a great exercise for the ankles in general is a heel toe raise. When you're standing, make sure you have something sturdy to hold on to, so you can use a chair a countertop even if you're next to a wall, just to have a little bit of balance because you want to make sure you're doing the exercise correctly. Start off with your feet about shoulder width apart, and you're just going to come up on your toes and then slowly come back down and bring your heels up, but make sure it's a slow controlled motion, so up on the toes high as you comfortably can, and then slowly down, and then bringing the heels up or the toes up.
When you bring the toes up, make sure you're not bringing them up by sticking your booty out, your actually lifting those toes up. So again going up nice and slow, coming back down, and then pull the toes, so if this is uncomfortable or painful, you might not quite be ready for it, but if it feels okay then work your way up to getting to 20-25.
If that's easy doing both of them, then you can go just to one foot, so same kind of thing where you're going up on your toes, and slowly coming down, and then pulling your toes up, but try not to stick out your booty when you do it, so it's really important to go nice and slow for that going down that eccentric motion, and then pulling the toes up and coming back up. So if you're just going fast and rocking back and forth using momentum, that's not really actually working those muscles, you're just using momentum to work them, so make sure you do a nice slow controlled motion. The next one is going to be a balance series. The balance works really really well for all those finer control ankle muscles, so it's it's really good getting everything strong again, strengthen those muscle tendons that go through that cube, not cubital tunnel, tarsal tunnel down into the foot, so really working them and getting those muscles stronger is important because if something's irritated, getting some strength back in it will help.
So this time you're just gonna stand on one foot again. Make sure you hold on to something to start off with, and then you can slowly progress to not holding on to anything, but just standing on one foot and start off with two hands just holding on to the chair or the counter top, start off with 10 to 15 seconds. Again if you have that tarsal tunnel syndrome, that's going to might be a little bit irritating, if it's not, then go ahead and just hold on with one hand, and then if you can easily get up to a minute with that then just try maybe holding on with one finger, but if you're pushing down if your fingers getting bent or your fingers hurting, you're still putting a little bit too much pressure on it and you're not quite ready for that, but then if you get to there then you can just balance without holding on at all.
And so as you can see, while I'm doing this my my ankles wiggling a little bit, my body's swaying just a little bit, that's completely normal, that's natural, that's just our body's way trying to find that center of gravity, so if your ankles moving a little bit that's okay, but if it's hurting while it's moving a little bit, then that's not okay, and then you're probably not quite ready for not holding on to anything, so go back to here and if that's still hurting, then you're probably not quite ready for that yet.
So those are your stretches and exercises for tarsal tunnel syndrome.