Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-28T06:02:00.467Z Has data issue: false hasContentIssue false
  • English
  • Français

An Unusual Presentation of Tarsal Tunnel Syndrome Caused by an Inflatable Ice Hockey Skate

Published online by Cambridge University Press:  02 December 2014

B.V. Watson ,
H. Algahtani ,
R.J. Broome  and
J.D. Brown
B.V. Watson
Affiliation:
Department of Clinical Neurological Sciences, London Health Sciences Centre, University Campus, London, Ontario, Canada
H. Algahtani
Affiliation:
Department of Clinical Neurological Sciences, London Health Sciences Centre, University Campus, London, Ontario, Canada
R.J. Broome
Affiliation:
Department of Clinical Neurological Sciences, London Health Sciences Centre, University Campus, London, Ontario, Canada
J.D. Brown
Affiliation:
Department of Clinical Neurological Sciences, London Health Sciences Centre, University Campus, London, Ontario, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Tarsal tunnel syndrome is a rare form of entrapment neuropathy. In athletes, it is usually the result of repetitive activity, local injury or a space-occupying lesion. Rarely, athletic footwear has been described as the primary cause of this syndrome.

Methods:

A 37-year-old male recreational hockey player was examined clinically and electrophysiologically because of spreading numbness in the toes of his left foot while playing hockey and wearing inflatable ice hockey skates designed to promote a better fit.

Results:

Clinical and electrophysiological studies revealed evidence of left medial and lateral plantar nerve involvement. Reduced amplitudes of mixed and motor plantar nerve responses with fibrillation potentials and positive sharp waves and no evidence of conduction block suggest that the primary pathology was axonal loss. Follow-up examination showed significant clinical and electrophysiological improvement after the patient stopped wearing his inflatable ice hockey skates.

Conclusion:

We report an unusual case of tarsal tunnel syndrome caused by an inflatable ice hockey skate. The patient improved clinically and electrophysiologically when he stopped wearing the boot.

Résumé:

RÉSUMÉ:Introduction:

Le syndrome du canal tarsien est une forme rare de neuropathie de compression. Chez les athlètes, il résulte habituellement de l’activité répétitive, d’une blessure locale ou d’une lésion compressive. Il est rare que les chaussures athlétiques soient la cause principale de ce syndrome.

Méthodes:

Un homme âgé de 37 ans, joueur de hockey récréatif, a subi une évaluation clinique et électrophysiologique parce qu’il présentait un engourdissement des orteils de son pied gauche pendant qu’il jouait au hockey avec des patin de hockey sur glace gonflables, conçus pour un meilleur ajustement.

Résultats:

Les études cliniques et électrophysiologiques ont montré une atteinte du nerf plantaire interne et externe gauche. Une diminution de l’amplitude des réponses mixtes et motrices du nerf plantaire, avec des potentiels de fibrillation et des ondes abruptes positives sans évidence de bloc de conduction, suggèrent que la pathologie primaire était une perte axonale. Le suivi a montré une amélioration clinique et électrophysiologique significative quand le patient a cessé de porter ses patins de hockey gonflables.

Conclusion:

Nous rapportons le cas inusité d’un syndrome du canal tarsien causé par un patin gonflable. La condition clinique et électrophysiologique du patient s’est améliorée quand il a cessé de porter les patins.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 29 , Issue 4 , November 2002 , pp. 386 - 389
Copyright
Copyright © The Canadian Journal of Neurological 2002

References

1. Hainline, B. Nerve injuries. Med Clin North Am 1994; 78(2):327–343.Google Scholar
2. Schon, LC. Nerve entrapment, neuropathy, and nerve dysfunction in athletes. Orthop Clin North Am 1994; 25(1):47–59.Google Scholar
3. Lorei, MP, Hershman, EB. Peripheral nerve injuries in athletes: treatment and prevention. Sports Med 1993; 16(2):130–147.Google Scholar
4. Murphy, PC, Baxter, DE. Nerve entrapment of the foot and ankle in runners. Clin Sports Med 1985; 4(4):753–763.Google Scholar
5. Henricson, AS, Westlin, NE. Chronic calcaneal pain in athletes: entrapment of the calcaneal nerve? Am J Sports Med 1984; 12:152–154.Google Scholar
6. Galardi, G, Amadio, S, Maderna, L, et al. Electrophysiologic studies in tarsal tunnel syndrome. Diagnostic reliability of motor distal latency, mixed nerve and sensory nerve conduction studies. Am J Phys Med Rehabil 1994; 73:193–198.CrossRefGoogle ScholarPubMed
7. Cimino, WR. Tarsal tunnel syndrome: review of the literature. Foot Ankle Int 1990; 11:47–52.Google Scholar
8. DeLisa, JA, Saeed, MA. The tarsal tunnel syndrome. Muscle Nerve 1983; 6:664–670.CrossRefGoogle ScholarPubMed
9. Fowler, TJ, Danta, G, Gilliatt, RW. Recovery of nerve conduction after a pneumatic tourniquet: observations on the hind-limb of the baboon. J Neurol Neurosurg Psychiat 1972; 35:638–647.Google Scholar
10. Yates, SK, Hurst, LN, Brown, WF. The pathogenesis of pneumatic tourniquet paralysis in man. J Neurol Neurosurg Psychiat 1981; 44:759–767.Google Scholar
11. Yamamoto, S, Tominaga, Y, Yura, S, Tada, H. Tarsal tunnel syndrome with double causes (ganglion, tarsal coalition) evoked by ski boots. Case report. J Sports Med Phys Fitness 1995; 35(2):143–145.Google Scholar
12. Kimura, J. Electrodiagnosis in Diseases of Nerve and Muscle: Principles and Practice. 3rd ed. New York: Oxford University Press, Inc., 2001.Google Scholar
13. Miller, RG, Peterson, GW, Daube, JR, Albers, JW. Prognostic value of electrodiagnosis in Guillain-Barre syndrome. Muscle Nerve 1988; 11: 769–774.CrossRefGoogle ScholarPubMed
14. Hirasawa, Y, Sakakida, K. Sports and peripheral nerve injury. Am J Sports Med 1983; 11(6):420–426.Google Scholar
15. Antonini, G, Gragnani, F, Vichi, R. Tarsal tunnel syndrome in skiers. Case report. Ital J Neurol Sci 1993; 14(5):391–392 CrossRefGoogle ScholarPubMed
16. Oh, SJ, Meyer, RD. Entrapment neuropathies of the tibial (posterior tibial) nerve. Neurol Clin 1999; 17(3):593–615.Google Scholar
17. Dumitru, D. Focal peripheral neuropathies. In: Electrodiagnostic Medicine. Philadelphia: Hanley & Belfus, Inc., 1995:905–908.Google Scholar
18. Bailie, DS, Kelikian, AS. Tarsal tunnel syndrome: diagnosis, surgical technique, and functional outcome. Foot Ankle Int 1998; 19(2):65–72.Google Scholar
19. Rask, MR. Medial plantar neurapraxia (jogger’s foot). Clin Orthop Rel Res 1978; 134:193–195.Google Scholar
20. Schon, LC, Baxter, DE. Neuropathies of the foot and ankle in athletes. Clin Sports Med 1990; 9(2):489–509.CrossRefGoogle ScholarPubMed
21. Fullerton, PM. The effect of ischaemia on nerve conduction in the carpal tunnel syndrome. J Neurol Neurosurg Psychiat 1963; 26:385–397.CrossRefGoogle ScholarPubMed
22. Oh, SJ, Sarala, PK, Kuba, T, et al. Tarsal tunnel syndrome: electrophysiological diagnosis. Ann Neurol 1979; 5:327–330.CrossRefGoogle Scholar
23. Jackson, DL, Haglund, B. Tarsal tunnel syndrome in athletes: case reports and literature review. Am J Sports Med 1991; 19(1):61–65.Google Scholar
24. Ward, PJ, Porter, ML. Tarsal tunnel syndrome: a study of the clinical and neurophysiological results of decompression. J R Coll Surg Edinb 1998; 43(1):35–36.Google Scholar
25. Wilbourn, AJ. Two uncommon nerve entrapment disorders: thoracic outlet syndrome and tarsal tunnel syndrome. AAN 52nd Annual Meeting, Apr 29-May 6, 2000, San Diego, California; Course # 2DS.010.Google Scholar
26. Radin, EL. Tarsal tunnel syndrome. Clin Orthop 1983; 181:167–170.Google Scholar