Case 007 - The Nerve That Went Underground

t's not always the fascia. Sometimes it's the nerve — and the nerve doesn't lie.

Tarsal tunnel syndrome is one of the most misdiagnosed conditions in injured runners. The foot burns. The arch tingles. It gets worse at rest, not on first steps. And yet it gets handed a plantar fasciitis diagnosis and a night splint, and sent on its way.

In this episode, we follow the tibial nerve into the tarsal tunnel — a narrow corridor of bone and retinaculum — and work through every suspect that could be squeezing it: space invaders, swollen tendons, pronating mechanics, post-traumatic scar tissue, and systemic nerve vulnerability.

We cover how to read the pattern, what Tinel's sign tells us, why nerve conduction studies can mislead early on, and what a proper rehabilitation plan actually looks like — from load modification to neural mobilisation to surgical decompression when all else fails.

This one's for the runners who've been told it's their fascia for six months. It might not be.