What is Medial Plantar Nerve Entrapment
Medial plantar nerve entrapment also called jogger’s foot, is a condition that happens when a nerve that passes from the inside of your ankle to your foot (medial plantar nerve) gets squeezed or compressed (entrapment) near a small bone near your arch (navicular bone).
Medial plantar nerve entrapment causes heel and foot pain, often in the arch of your foot. The pain usually gets worse with activity.
What are the causes?
Medial Plantar Nerve Entrapment is caused by compression of the medial plantar nerve between muscles, bones, or connective tissues in the inner arch area.
What increases the risk?
Medial Plantar Nerve Entrapment is more likely to develop in:
- Runners, especially those who run long distances or have flat feet.
- People who wear stiff shoe inserts (orthotics) that may put pressure on the foot and nerve.
- People whose feet roll inward and flatten too much when they stand, walk, or run (over-pronate).
What are the symptoms of Medial Plantar Nerve Entrapment?
Pain in the heel and foot is the most common symptom of this condition.
The pain may:
- Feel sharp or achy.
- Be felt only when standing or running at first. It may get worse until you feel pain all the time, even at rest.
- Be focused in your arch or also include your big toe and second toe. You may have pain under your foot and toes or near your toenails.
How is this diagnosed?
Medial Plantar Nerve Entrapment is diagnosed based on your symptoms, medical history, and a physical exam. During the physical exam, your health care provider may press or near your arch and heel to see if that causes your symptoms. You may also have numbing medicine injected into the nerve area to see if that relieves your pain. You may have other tests, including:
- X-rays to check bone structure.
- MRI or ultrasound to examine nerve and tendon structures.
- An electrical study of nerve function (electromyogram, or EMG).
How is this treated?
Treatment of Medial Plantar Nerve Entrapment may include:
- Decreasing your walking or running distance.
- Walking or running on a softer surface, like a dirt trail.
- Wearing a removable splint or boot for foot and ankle support.
- Using a softer shoe orthotic that supports your foot but does not put any extra pressure on the nerve.
- Using ice to reduce swelling.
- Taking pain medicine.
- Getting injections in the nerve area with medicines to reduce pain and swelling.
- Starting range-of-motion exercises and strengthening exercises (physical therapy).
- Returning gradually to full activity. This will depend on the severity of the condition and your response to treatment.
If nonsurgical treatments have not helped, you may need surgery to relieve the compression. After surgery, you may need to wear a removable splint or boot for support and eventually have physical therapy.
Managing pain, stiffness, and swelling
- If directed, apply ice to the injured area.
- Put ice in a plastic bag.
- Place a towel between your skin and the bag.
- Leave the ice on for 20 minutes, 2–3 times a day.
- Move your toes often to avoid stiffness and to lessen swelling.
- Raise (elevate) your foot above the level of your heart while you are sitting or lying down.
Driving
- Do not drive or operate heavy machinery while taking prescription pain medicine.
- Ask your health care provider when it is safe to drive if you have a splint or boot on your foot.
Activity
- Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
- Do exercises as told by your health care provider.
General instructions
- Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. Tobacco can delay healing. If you need help quitting, ask your health care provider.
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Keep all follow-up visits as told by your health care provider. This is important.
How is Medial Plantar Nerve Entrapment prevented?
- Give your body time to rest between periods of activity.
- Wear comfortable and supportive shoes during athletic activity.
Follow these instructions at home:
If you have a splint or boot:
- Wear the splint or boot as told by your health care provider. Remove it only as told by your health care provider.
- Loosen the splint or boot if your toes tingle, become numb, or turn cold and blue.
- If your
splint or boot is not waterproof:
- Do not let it get wet.
- Cover it with a watertight covering when you take a bath or a shower.
- Keep the splint or boot clean.
Contact a health care provider if:
- Your pain is not improving or is getting worse.
Medial Plantar Nerve Entrapment Rehabilitation
Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.
Here are the Rehabilitation procedures for Medial Plantar Nerve Entrapment
Stretching and range of motion exercise
This exercise improves the movement and flexibility of your lower leg and foot. This exercise may also help to relieve pain, numbness, and tingling.
Exercise A: Gastrocnemius, standing
- Stand with your hands against a wall.
- Extend your left / right leg behind you and bend your front knee slightly.
- Keeping your left / right heel on the floor and your back knee straight, shift your weight toward the wall without arching your back. You should feel a gentle stretch in the back of your lower leg (calf).
- Hold this position for __________ seconds.
- Return to the starting position.
Repeat __________ times. Complete this exercise __________ times a day.
Strengthening exercise
This exercise builds strength and endurance in your foot. Endurance is the ability to use your muscles for a long time, even after they get tired.
Exercise B: Arch lifts (foot intrinsics)
- Sit in a chair with your feet flat on the floor.
- Keeping your big toe and your heel on the floor, lift only your arch, which is on the inner edge of your left / right foot. Do not move your knee or scrunch your toes. This is a small movement.
- Hold this position for __________ seconds.
- Slowly return to the starting position.
Repeat __________ times. Complete this exercise __________ times a day.
Summary
Medial plantar nerve entrapment or compression syndrome, also known as jogger’s foot is a nerve compression syndrome of the medial plantar nerve either in the distal tarsal tunnel or beneath the plantar arch at the knot of Henry.
