Running Into Ankle Injuries

For many people, running is an enjoyable pastime. The activity allows for immersion in nature, is a great way to stay in shape, and can also boost mood thanks to endorphins. However, running can lead to frequent injuries because of the anatomy of the foot or repetitive movement. Tarsal tunnel syndrome (TTS) can occur from running, and in many cases, surgery is required to correct the problem. Knowing when to begin running again after surgery is important to ensure that the foot has adequately healed.

What is tarsal tunnel syndrome?

Located on the inside of the ankle, the tarsal tunnel is formed by the ankle bones and ligaments. Tarsal tunnel syndrome is an injury that can occur because of compression in that area. Similar to how carpal tunnel is caused by compression of the median nerve, with TTS, the posterior tibial nerve is compressed. As a result, people can experience tingling, numbness, and even pain in the foot. Although flat feet, diabetes, and arthritis can all cause the syndrome, injuries like ankle sprains can also be the culprit.

Tarsal tunnel release surgery

Not every person with tarsal tunnel syndrome will need surgery. For example, many individuals can manage symptoms with at-home treatments such as the RICE protocol, which includes rest, ice, compression, and elevation. Over-the-counter (OTC) anti-inflammatory medication can also help. Meanwhile, other people may need steroid injections to control swelling, along with the use of braces or splints to immobilize the joint. For more severe cases, surgery is necessary. Tarsal tunnel release surgery is a minimally invasive procedure where surgeons use small instruments to stretch the ligament. The process reduces pressure on the posterior tibial nerve.

Post-operative expectations

Recovery from tarsal tunnel release surgery can take some time. Keep in mind that the ankle joint bears a significant amount of weight, so the area must be fully healed before more strenuous activities can be resumed. Although the process is an outpatient procedure, people undergoing surgery should expect to spend anywhere from 1-3 weeks with the affected foot in a cast or walking boot. The boot may sometimes be needed for up to 6 weeks.

When to resume running

Individual recovery progress will directly dictate when a runner can return to hitting the trail. General guidance suggests that 8-16 weeks after surgery, the foot should be improved enough for sports activities like running to be resumed. However, runners should always consult with the surgeon before beginning activities again.

Avoiding TTS in the first place

For many people, especially non-runners, TTS occurs because of a genetic predisposition due to the foot’s shape or an underlying disease like arthritis or diabetes. However, for runners, the condition can sometimes be avoided. For example, avoiding more challenging terrain on uphill paths can minimize the risk of aggravating the posterior tibial nerve. People concerned about tarsal tunnel syndrome and possible treatment complications should speak with a specialist.