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Rugby 101

Injury and recovery

Tarsal Tunnel Syndrome in Rugby

Burning under the foot that gets worse in cleated boots

2 min readIntermediate

Tarsal tunnel syndrome is compression of the posterior tibial nerve as it runs behind the inner ankle bone. Rugby players often present with burning, tingling, or numbness on the sole of the foot — worse after running on hard ground or playing in stiff cleated boots. Most cases respond to conservative care that addresses biomechanics, footwear, and neural mobility.

What it is

Inside your ankle, on the side closest to the other foot, there's a narrow channel called the tarsal tunnel. A big nerve called the posterior tibial nerve passes through it on its way down to the sole of your foot. If that nerve gets squeezed in the tunnel, you can feel burning, pins-and-needles, or numbness under the foot. That's tarsal tunnel syndrome — sometimes called the foot's version of carpal tunnel.

What it feels like

  • Burning or tingling under the arch, heel, or toes
  • Symptoms that get worse the longer you stand, run, or play
  • Pain or zinging when the inside of the ankle is tapped firmly
  • Symptoms worse in stiff cleated boots or on hard, dry pitches
  • Sometimes a sense the sole 'isn't quite there' or feels muffled

How is it different from plantar fasciitis?

Plantar fasciitis usually hurts most for the first few steps in the morning and is a sharp, pinpoint pain on the heel or arch. Tarsal tunnel symptoms are more often burning, tingling, or numb — and they tend to get worse the more you're on your feet, rather than easing up as you warm into the day. The two can overlap, so a physio will assess to be sure.

What usually helps

  • A physiotherapist's assessment to rule out the common look-alikes (plantar fasciitis, sciatic referral, peripheral neuropathy)
  • Reviewing footwear — softer studs for hard pitches, a wider boot, or a moulded insole
  • Addressing pronation and ankle stability with strength work and short-foot training
  • Neural-glide exercises that gently slide the nerve through the tunnel

When to seek imaging or specialist input

  • Persistent numbness or weakness rather than just discomfort
  • Symptoms that don't change after 6-8 weeks of physio-led care
  • A clear lump, ganglion, or post-fracture bony prominence at the medial ankle
  • Symptoms after an ankle fracture or surgery

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