Tarsal tunnel syndrome (TTS) is categorized as the entrapment of the posterior tibial nerve or one of its medial or lateral branches as it passes through the tarsal tunnel of the ankle (Starkey & Brown, 2015). This syndrome will cause pain, paresthesias, and abnormal sensation in the medial hindfoot and plantar aspect of the foot (Trepman et al, 1999). A positive Tinel’s sign at the flexor retinaculum and abnormalities is one way of determining if a patient is suffering from TTS, another method is through the use of a special test called dorsiflexion-eversion test. When it comes to TTS the primary complain of the patients are diffuse pain, burning, paresthesia, and numbness along the plantar and medial aspect of the foot (Starkey & Brown, 2015).…show more content… He believed that the clinical diagnosis of tarsal tunnel syndrome lacked objectivity and consistency (Kinoshita et al, 2001). Kinoshita et al observed a specific patient with flatfoot and TTS who was reporting having pain when toeing off forcefully and by passively positioning this patients foot in full dorsiflexion with the heel everted, Kinoshita et al were able to reproduce the signs and symptoms of the patient whiting a few seconds. They then decided to evaluate this particular test while doing so on fifty normal volunteers (100 feet) and on thirty-seven patients (44 feet) that had issues with TTS. The dorsiflexion-eversion test was performed before, during, and after surgery in all the TTS patients, while observing if any changes would occur after the surgeries. The results showed that the test induced no signs and symptoms in the control group, however in 36 of the 44 feet with TTS the subjects/patients had an increase in their signs and symptoms. The dorsiflexion-eversion test is very simple test to administer it entitles the practitioner to passively maximally dorsiflexion and evert the ankle of the patient while all the metatarsophalangeal joints are also maximally dorsiflexed and held in this position for five to ten seconds (Kinoshita et al, 2001). A positive sign for the test is provocation or increase in signs and symptoms of TTS such as pain, numbness, and paresthesia. The…show more content… It was very evident that the dorsiflexion-eversion test was approved throughout the board and that every other believed that by dorsiflexion and eversion the foot this would compress the tibial nerve onto the retinaculum and would increase the signs and symptoms of the patients and if this test is positive that the patient is most likely suffering from tarsal tunnel syndrome. I found it interesting that Trepman et al demonstrated an increase tension in the tarsal tunnel when the foot was also inverted in cadavers and this made me wonder if we would dorsiflex and invert if this would also reproduce the signs and symptoms of the patient. Anatomically this doesn’t make very much sense to me since I don’t see inversion compression the medial aspect of the ankle and compressing the tibial nerve, however it could be a possibility. This as great clinical implication for myself since I am know able to administer a very valid and reliable test in order to help myself diagnose or rule out tarsal tunnel syndrome in my patients. It was said in our textbook that TTS are often confused with the symptoms produced by plantar fasciitis, hence this special test would be able to help make the difference between a patient who is suffering from TTS and plantar fasciitis.
