Dimensional changes of the tibial nerve and tarsal tunnel in different ankle joint positions in asymptomatic subjects.

Review written by Dr Carlo Wood info

Key Points

  • The tarsal tunnel anterior-posterior distance (APD) increases during plantarflexion (PF) and decreases during dorsiflexion (DF).
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Tarsal tunnel syndrome manifests as pain, paresthesia, hypo/hyperesthesia, cramps, and numbness at the heel, sole of the foot and toes with walking, sprinting, and jumping, but may also be present at rest. It can be caused by trauma, space-occupying lesions, and deformities of the foot like a valgus heel and abducted forefoot. Hypermobility into eversion and DF compress the tibial nerve by decreasing the size of the tarsal tunnel, and also places tension on the nerve.

The aim of this study was to quantify changes in the nerve and tarsal tunnel at different ankle positions.

Tarsal tunnel syndrome can be caused by trauma, space-occupying lesions, and deformities of the foot.
A plantarflexed position should decrease pressure in the tarsal tunnel and therefore decrease the pressure on the tibial nerve via a static or dynamic opener of the interface.


13 subjects were recruited for the study. Participants’ ankles were placed in neutral, DF and PF for ultrasound (US) examination. An US probe was positioned perpendicular to the nerve at the level of the tarsal tunnel. The anterior-posterior distance (APD)

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