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QUESTION: Leslie

Thanks in advance

Ive a vague diagnosis of tarsal tunnel syndrome, despite al radiology tests being normal and asteroid injection failing.

I read that strengthening exercises can help the condition, and patients usually have a history of sprained ankles.

QUESTION- ive very loose/hypermobile ankles, after many sprained ankles (footabll) - so i got offered a procedure to tighten the ligaments around the ankle......-- would this address the tarsal tunnel situation too indirectly?

Thanks

David

ANSWER: David,

This is a difficult question.  Tarsal tunnel syndrome (TTS) is an entrapment of the tibial nerve at the level of the ankle joint.  It can be caused by several different forms of entrapment.  Varicose veins, scar tissue, and severely flat feet are just some of the more common causes.  I am not aware of any case studies where loose ligaments from chronic ankle sprains have been the cause for TTS.  First and foremost, Tarsal tunnel syndrome is a difficult diagnosis, usually a diagnosis of exclusion.  Radiology tests and steroid injections do not usually confirm or deny a diagnosis of Tarsal Tunnel.  There are nerve conduction studies available that can narrow a diagnosis of TTS; however, false negatives are common with patients that have early developing TTS.  Usually nerve conduction studies or EMG studies that are positive for TTS are in patients with long-standing symptoms that have been dealing with it for years.

If you have hypermobility b/c of chronic ankle sprains, then a lateral ankle stabilization would definitely provide the stability that you lack to the ankle from previous sprains, but I would not count on it treating the TTS.  If you wear an ankle brace that laces-up or figure-8 around the ankle, does that cause the TTS symptoms to subside?  If so, then a lateral ankle stabilization may help you.  However, a lateral ankle stabilization is essentially an internal ankle brace preventing excessive motion to the ankle joint.  So if a supportive ankle brace does not relieve your symptoms of TTS, then I would not expect a lateral ankle stablization to alleviate it either.  You should check out our website on Tarsal Tunnel Syndrome under foot disorders for a better understanding of symptoms, evaluation and treatment.  Please let me know if there is anything else I can do for you.

Sincerely


Dr. Leslie Johnston, DPM
Tampa, FL
Advanced Podiatry

http://www.thetampapodiatrist.com
http://tampafootandanklepain.blogspot.com/
http://www.tampacryosurgery.com
http://katzpodiatristtampa.blogspot.com
http://twitter.com/TampaPodiatrist
http://www.notoenailfungus.com
http://www.vibranttampatoenails.com  
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---------- FOLLOW-UP ----------

QUESTION: thanks so much Leslie!

erm...what type of ankle support should i be looking at?

do you have any links to a support that i could get here in the Uk?

Thanks

David!

Answer
David I personally like the ASO ankle brace.  It has a lace up front and figure-8 velcro strap on the side.  Provides good stability but also allows the ankle to move well in sports-related activities.

Sincerely


Dr. Leslie Johnston, DPM
Tampa, FL
Advanced Podiatry

http://www.thetampapodiatrist.com
http://tampafootandanklepain.blogspot.com/
http://www.tampacryosurgery.com
http://katzpodiatristtampa.blogspot.com
http://twitter.com/TampaPodiatrist
http://www.notoenailfungus.com
http://www.vibranttampatoenails.com  
Advanced Podiatry Facebook Page
http://www.facebook.com/profile.php?id=100000260088035  

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Leslie Johnston

Expertise

any podiatry related question. bunions, hammertoes, arthritis in foot and ankle, lumps and bumps, foot pain, ankle pain, neuromas, heel pain, plantar fasciitis, diabetic foot care, ulcers, neuropathy, charcot, ankle replacements, trauma, sports medicine, Achilles injuries, ankle sprains ect.

Experience

Currently working as an Associate for Advanced Podiatry in Tampa, FL. Finished 3 year surgical residency with additional certification in rearfoot and ankle reconstruction. Worked in wound care clinic at Veteran's Hospital using advance wound care techniques.

Organizations
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Education/Credentials
DPM degree earned from the Ohio College of Podiatric Medicine 2005-2009 completed 3 year podiatric medical and surgical residency training at James A. Haley VA 2009-2012. Board qualified status for American Board of Podiatric Surgeons in foot and rearfoot and ankle surgery 2012.

Awards and Honors
1st runner up in Resident case presentations at annual Science and Management Symposium 2012 Who's who among colleges and universities 2009

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