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Orthotics made for tarsal tunnel syndrome.

Posted by Bruce on 7/24/03 at 07:45 (125121)

I had orthotics made for by my podiatrist because I have tts and I really don't understand the consept. In what way could they help? And what is the usual cause of tts?I know when you have carpal tunnel you wear a brace but an orthotic doesn't go around your ankle so it is confusing.So far I haven't been doing so great with the orthotics, they really bother my knees even wearing them about an hour a day for the last 2 weeks so if the way I am walking is causing the tts and I can't tolerate the orthotics than the condition is not going to imrove.Would someone please try to explain why orthotics are prescribed? Thanks, Bruce

Re: Orthotics made for tarsal tunnel syndrome.

Ed Davis, DPM on 7/27/03 at 17:17 (125370)

Orthotics would only help tarsal tunnel syndrome if there is a significant biomechanical component to the problem such as overpronation.
For example, if your foot rolls in too much (overpronation), then that can place additional stretch on the laciniate ligament (the ligament that forms the roof of the tarsal tunnel).

Re: Orthotics made for tarsal tunnel syndrome.

Dr Kiper on 7/30/03 at 14:53 (125698)

TTS is secondary to overpronation. It is a repetitive injury. The intent of an orthotic (similar to a brace for the arm), is to minimize the motion (overpronation) and reverse the degree of accumulated inflammation.

The reason for your poor results and especially your added problems, is that your orthotics do not fit correctly and do not match the way your mechanics work. This of course is the reason any orthotic doesn't work and/or creates other problems.

Even if your orthotics do fit correctly, recovery from tendon and ligamentous injuries can take a long time to 100% resolution, therefore a correct fit is essential.

Re: Orthotics made for tarsal tunnel syndrome.

Ed Davis, DPM on 7/30/03 at 21:50 (125732)

Dr. Kiper:

I suspect that a certain amount of TTS is due to subtalar joint overpronation. There is not much in the literature to support that though.

Much has been written about the types of repetitive trauma that lead to carpal tunnel syndrome. It is reasonable to assume that tarsal tunnel syndrome may have an analogous cause. Space occupying lesions are often a culprit with TTS with varicosities comprising about 25 to 30% of such cases.