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Running with Tarsal Tunnel Syndrome

Posted by Justin Z on 8/25/01 at 13:44 (057939)

I am a 20 year-old runner who logged 30 miles a week until 6 months ago. Since then, I have experienced 3 recurrances of TTS despite arch-support, a NSAID, dramatic cut backs in my volume and intensity.
My only concern is returning to my previous training load and preparing to try out for my school team next season, which will be my senior year. However, my PCP suggested that I may have to quit running since the pain did not respond to the first trial of arch-support. Next, a Bone and Joint surgeon prescribed custom-made orthotics as well as Feldene. If this proves to be ineffective, what is the next best course of action? I have heard contradicting recommendations on cortizone injections and have heard that surgery may make the condition worse than before.
I have little pain when walking, but the nerve is still sore to the touch after 5 weeks of inactivity.
Is there any chance that the pain will fully heal? Will I be forced to quit running? Please respond with honest answers.

Re: Running with Tarsal Tunnel Syndrome

Ed Davis, DPM on 8/25/01 at 16:06 (057952)

I don't think that all of your questions can be answered completely without an exam but we can talk in generalities.

You state that you had '3 recurrences' of TTS. Either you have TTS or you do not--it does not come and go, usually. Perhaps you mean that you have had recurrence of the symptoms consistent with TTS. Are you positive about the diagnosis? Have you had a nerve conduction velocity test?

You are very young to have TTS. How much running do you do? What is your occupation-- any repetitive motions with your feet? Are your feet overpronated? Do you have any types of arthritis? Do any of your family members have arthritis? Diabetes?

Describe your symptoms as completely as possible.

How were your orthotics constructed? Were you laying on a table while your feet were manipulated into a 'corrected' position before the molds taken of your feet? How long have you worn the orthotics?

I would be wary of surgery until you have exhausted conservative options including biomechanics and are very sure of the accuracy of the diagnosis.

Cortisone may be beneficial to potentially remove scar tissue from around the nerve. You are very young to have scar tissue about the nerve in the absence of injury, diabetes or arthritis. An MRI may be valuable to take a better look at the area.
Ed

Re: Running with Tarsal Tunnel Syndrome

Ed Davis, DPM on 8/25/01 at 16:06 (057952)

I don't think that all of your questions can be answered completely without an exam but we can talk in generalities.

You state that you had '3 recurrences' of TTS. Either you have TTS or you do not--it does not come and go, usually. Perhaps you mean that you have had recurrence of the symptoms consistent with TTS. Are you positive about the diagnosis? Have you had a nerve conduction velocity test?

You are very young to have TTS. How much running do you do? What is your occupation-- any repetitive motions with your feet? Are your feet overpronated? Do you have any types of arthritis? Do any of your family members have arthritis? Diabetes?

Describe your symptoms as completely as possible.

How were your orthotics constructed? Were you laying on a table while your feet were manipulated into a 'corrected' position before the molds taken of your feet? How long have you worn the orthotics?

I would be wary of surgery until you have exhausted conservative options including biomechanics and are very sure of the accuracy of the diagnosis.

Cortisone may be beneficial to potentially remove scar tissue from around the nerve. You are very young to have scar tissue about the nerve in the absence of injury, diabetes or arthritis. An MRI may be valuable to take a better look at the area.
Ed