I am. dawson: March 2010

March 12th.

I'm getting surgery.

I first noticed the pain while snowboarding, about 7 years ago. Being a newbie to the sport, I didn't think much of it. Then it started happening at the gym. Whenever I would run (either on the treadmill, elliptical machine or outside) longer than 20-25 minutes, my feet would start to burn, then ache, and then fall asleep. Once again, I didn't think much of it--I just figured it was a problem with my shoes or the way I landed on my feet. Now, 7 years of "playing-through-the-pain" later, and I can't make it a full snowboard run down the mountain without stopping numerous times, or run more than 10-15 min. without quitting from intense pain.

Lame.

I figured this probably wasn't normal, so I decided to visit the podiatrist. Over several months of various exams and tests, two EMG's and an MRI, the conclusion is that I've got
tarsal tunnel syndrome.
Tarsal tunnel syndrome (TTS), also known as posterior tibial neuralgia, is a painful foot condition in which the tibial nerve is impinged and compressed as it travels through the tarsal tunnel. TTS is a compression syndrome of the tibial nerve within the tarsal tunnel. This tunnel is found along the inner leg behind the medial malleolus (bump on the inside of the ankle). The posterior tibial artery, tibial nerve, and tendons of the tibialis posterior, flexor digitorum longus, and flexor hallucis longus travel in a bundle along this pathway, through the tarsal tunnel. In the tunnel, the nerve splits into three different paths. One nerve (calcaneal) continues to the heel, the other two (medial and lateral plantar nerves) continue on to the bottom of the foot. The tarsal tunnel is made up of bone on the inside and the flexor retinaculum on the outside.
Patients complain typically of numbness in the foot, radiating to the big toe and the first 3 toes, pain, burning, electrical sensations, and tingling over the base of the foot and the heel. Depending on the area of entrapment, other areas can be affected. If the entrapment is high, the entire foot can be affected as varying branches of the tibial nerve can become involved. Ankle pain is also present in patients who have high level entrapments. Inflammation or swelling can occur within this tunnel for a number of reasons. The flexor retinaculum doesn’t stretch much, so increased pressure will eventually cause compression on the nerve within the tunnel. As pressure increases on the nerves, the blood flow decreases. Nerves respond with altered sensations like tingling and numbness. Fluid collects in the foot when standing and walking and this makes the condition worse. As small muscles lose their nerve supply they can create a cramping feeling.

I didn't feel like typing all of that, so a big thanks to Wikipedia for the definition.

As of now, my pain is only when I'm exercising (lucky me). Even though the surgery success rate is not very high, I've decided to go ahead with it. I've tried all the other options (rest, compression, orthotics, cortizone pills/injections, etc.) and none have worked, so this surgery is sort of a 'hail mary' pass. My doctor and I are hoping that the surgery will curtail further nerve damage and hopefully encourage nerve regeneration.

Fingers crossed!