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Tarsal tunnel syndrome (TTS) - Coggle Diagram
Tarsal tunnel syndrome (TTS)
Tests
Tinel's sign over tibial nerve.
Provocation during dorsi flexion and eversion. - pull up toes to, this will mimic a Phalen's equivalent.
Subjective
Pt may report tingling, shooting, numbness, burning in medial portion of ankle. This may radiate.
Aggs: stairs, weight bearing, walking, running and prolonged standing.
High prevalence in women but can occur at ay age.
Can be acute or chronic.
May or may not be a history of MOI.
Worse as day goes on.
Objective
Palpation: tenderness located posterior to medial aspect of malleolus.
PROM: evert and dorsiflex can replicate symptoms.
Neuro testing may reveal change in myotomes and dermatomes.
Depending on stage may be some swelling present. Advanced cases may have slight atrophy.
Weakness may be present.
Research
Overview - Tarsal Tunnel
Syndrome.
https://www.youtube.com/watch?v=x4wPSqPm0Uo
Why this and nothing else
Localisation over post tibial nerve.
Other differentials can be discounted.
Unique presentation.
Differentials
Stress fracture
Achilles tendinopathy
Plantar fasciitis
Posterior tibialis tendon disorder
Pathology
Presents as pain radiating into the foot. Weakness and loss of sensation may be present.
Tunnel located posterior to medial malleolus.
Compression of the posterior tibial nerve leading to neuropathy (dysfunction).
A rare condition with a multitude of causes.
Treatment