Written by: Cherri Choate, DPM
11/25/2009

A publication (Kinoshita 2002) referenced in the Journal Club section of our web site a few weeks ago focused on the effect of foot position in tarsal tunnel syndrome. The researchers  presented a quick easy clinical exam where the foot and ankle were held in a dorsiflexed and everted position for a few minutes. When this test was conducted in patients with diagnosed tarsal tunnel syndrome, 84% had an increase in symptoms. 

So how does this translate to orthotic therapy?  If we apply the above data to a stance situation, with ground reactive forces now acting as the hand did in the exam, we can intervene with a device that avoids the dorsiflexed and everted position.  Here are some possible options:
              Avoiding dorsiflexion- minimal fill, deep heel cup, wide plate, heel lift
                                                             Avoiding eversion- medial skive, inversion, deep heel cup, wide plate
                                                Just some ideas to help when treating patients with tarsal tunnel syndrome.

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