Fibularis syndrome - anterior tarsal tunnel syndrome

In the course of our lives, our feet probably complete the 160,000 kilometers, four times a march along the equator around the earth. It is important that their function is guaranteed in order to always be able to move well. Walking difficulties due to weakness and numbness in parts of the foot and lower leg, such as occur in the so-called Fibularis syndrome (anterior tarsal tunnel syndrome), can be a significant limitation here.

contents

• Synonyms
• Complaints and symptoms
• Causes of anterior tarsal tunnel syndrome

Synonyms

Anterior tarsal tunnel syndrome, fibular compression, anterior tarsal tunnel syndrome, cylinder distorsion of the back of the foot, lower leg trigger ligament, AACD, anterior ankle continuum distorsion.

The Fibularis syndrome causes sensation of discomfort and pain while walking, which can lead to significant restrictions in everyday life. (Image: koszivu / fotolia.com)

Complaints and symptoms

Most of the time, there is a lack of coordination of the feet and disturbances in the sensitivity of the big and second toes, which in turn can cause walking difficulties. In addition, often a muscle weakness in the foot and in the calf. Complaints are often triggered when one presses on the narrowing point or e.g. wearing too tight footwear. This facilitates a meaningful diagnosis and often at the same time the treatment.

Causes of anterior tarsal tunnel syndrome

In medicine, the Fibularis syndrome is also called the "front tarsal tunnel syndrome". This results in a clamping of the deep branch of the common fibular nerves, the Nervus fibularis profundus (formerly called Nervus peroneus profundus). Its fibers originate from the 4th lumbar vertebra (L4) to the first sacral vertebra (S1) and supply the extensor muscles of the calf and the skin between the big toe and the second toe.

Wearing close, tall shoes and increased stress are considered to be possible triggers of the symptoms of fibularis syndrome. (Image: anzebizjan / fotolia.com)

The nerve runs in depth along the shin and can be clamped at the forefoot by a band that runs across the foot above the instep. Just as in the case of the (posterior) tarsal tunnel syndrome, the suspected cause is a previous injury or illness, which can then lead to constriction due to bruising or swelling of the tissue. Even during pregnancy, menopause or hormonal imbalances, anterior tarsal tunnel syndrome may occur. Other diseases such as tumors and chronic circulatory disorders or systemic diseases should be excluded.

The path of the nerve should be followed and examined from its point of passage under the external rotating gluteal muscle, the M. piriformis. Some authors, such as the French expert on osteopathy Jean Pierre Barral, also point to the possibility of compression on the fibular head, on which the nerve runs very closely along. In case of a fracture of the fibular head or a hardening, it could also come to a jamming. (Tf, fp)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)