Jan 12, 2026
Tarsal Tunnel Syndrome: What It Is & How Physical Therapy Helps
Welcome to "Movement Matters," Your Guide to Wellness!
Written by Dr. Rachael MacGregor DPT, DMT, FAAOMPT
Foot pain, tingling, or numbness? You’re not alone. One often-overlooked cause is Tarsal Tunnel Syndrome—and the good news is that most cases respond very well to conservative care.
What Is Tarsal Tunnel Syndrome?
Tarsal Tunnel Syndrome occurs when the tibial nerve, a major nerve that travels from the lower leg into the foot, becomes compressed or irritated as it passes through a narrow space on the inside of the ankle called the tarsal tunnel.
This tunnel is formed by bones and a thick band of tissue, leaving little room for swelling or irritation. When pressure builds in this area, the nerve becomes sensitive, leading to symptoms that may come and go—or gradually worsen over time.
Common Symptoms
Pain along the inside of the ankle or arch of the foot
Tingling, numbness, or “pins and needles” in the foot or toes
Burning or electric-like sensations
Symptoms that worsen with prolonged standing, walking, or activity
Nighttime discomfort after a long day on your feet
Common Causes
Tarsal Tunnel Syndrome rarely has just one cause. Most often, symptoms develop when foot mechanics, activity demands, and tissue irritation combine.
Common contributing factors include:
Repetitive or prolonged standing, walking, or running
Flat feet or overpronation that increase strain on the inner ankle
High arches that reduce shock absorption
Swelling following an ankle sprain, fracture, or surgery
Poorly supportive footwear or worn-out shoes
Prolonged use of tight footwear or braces
Conditions that increase inflammation or fluid retention
Identifying and addressing the underlying contributors is key to long-term relief.
How Is Tarsal Tunnel Syndrome Treated?
Early treatment focuses on reducing nerve irritation while keeping the foot and ankle moving safely.
Effective at-home strategies may include:
Staying active within comfort – avoiding painful overuse while preventing stiffness
Activity modification – reducing high-impact or prolonged weight-bearing temporarily
Ice or heat to manage pain and swelling (depending on symptom response)
Over-the-counter medications, if safe and approved by your healthcare provider
Supportive footwear or orthotics to improve alignment and reduce nerve stress
Consistency with these strategies often leads to steady improvement over time.
Exercise Spotlight: Supporting the Foot & Ankle
Gastrocnemius (Calf) Stretch
Stand facing a wall with one foot forward and the affected leg behind you
Keep the back knee straight and heel flat on the floor
Gently lean forward until a stretch is felt in the upper calf
Soleus Stretch
Begin in a similar position as the calf stretch
This time, slightly bend the back knee while keeping the heel down
You should feel the stretch lower in the calf, closer to the Achilles tendon
Lower Extremity Nerve Glides
These movements are gentle and should not cause sharp pain or lingering symptoms
The goal is to encourage smooth nerve motion rather than an aggressive stretch
Banded Ankle Inversion
Sit with a resistance band secured to the outside of your foot
Slowly turn the foot inward against the band’s resistance
Return to the starting position with control
We’re here to help you stay active, mobile, and comfortable—starting from the ground up.
📞 Contact our clinic to schedule an evaluation or learn how physical therapy can help relieve foot and ankle pain and get you back to the activities you enjoy.