yogabook / pathology / anterior tarsal tunnel syndrome

Definition

Nerve compression syndrome of the profundus fibular nerve at the ankle or dorsalis pedis. The back of the foot below the
retinaculum extensorum inferius or retinaculum extensorum superius. Usually, the posterior tarsal tunnel syndrome is referred to as „tarsal tunnel syndrome“, which is correct, as only there the actual tarsal tunnel syndrome behind the malleolus medialis is affected, so that the term „anterior tarsal tunnel syndrome“ is incorrect and should only be understood as an analogy.

Cause

1. Wearing high shoes, ski and mountain boots, tightly laced shoes
2. Ganglion
3. Constrictions of the tendon sheaths
4. traumatic
5. Metabolic diseases such as diabetes mellitus
6. Foot malpositions
7. Osteophytes (e.g. in OSG-arthrosis)
8. Synovial cysts of the OSG
9. Compression due to tumours
10. Oedema of the lower leg
11. Thrombosis of the dorsalis pedis artery
12. possibly without recognisable cause

Predisposing

1. Changes in the foot, ankle or lower leg (see cause)

Diagnosis

1. Medical history and clinic
2. Nerve conduction measurement if necessary
3. Ultrasound to visualise possible soft tissue swelling, X-ray to visualise possible bony changes, MRI if necessary to assess ligaments, muscles and rule out tumours and inflammation
4. Tests and signs: Tinel test for the fibularis profundus

Symptoms

1. Exercise-induced pain, usually on the back of the foot near the ankle
2. possibly night pain, rest pain
3. Possibly paraesthesia between the 1st and 2nd toe
4. possibly innervation disorders of the intrinsic toe extensors extensor digitorum brevis and extensor hallucis brevis.

Complications

Therapy

1. Normally conservative: stop straining, taping
2. Therapy of causative or predisposing factors

DD