Tinel Sign Ankle | Nerve Entrapment | Tarsal Tunnel Syndrome

The Tinel Sign is a common neurological test that is used at different locations of the body. Amongst others at the wrist for Carpal Tunnel, at the Brachial Plexus for Thoracic Outlet Syndrome, at the ulnar nerve for Ulnar Neuropathy, and eventually at the ankle to assess the anterior tibial branch of the deep peroneal nerve and to examine for tarsal tunnel syndrome.
Schwieterman et al. (2013) include the Tinel Sign in their systematic review. The authors report a sensitivity of 58% but they could not provide any specificity percentage.

The Tinel Sign can be elicited in two places around the ankle. First, there’s the anterior tibial branch of the deep peroneal nerve which you would assess by tapping anterior to the medial malleolus.

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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Other orthopedic tests to assess tarsal tunnel syndrome are:

• Triple Compression Stress Test
• Dorsiflexion-Eversion Test

Oloff LM, Schulhofer SD. Flexor hallucis longus dysfunction. The Journal of foot and ankle surgery. 1998 Mar 1;37(2):101-9.

Schwieterman B, Haas D, Columber K, Knupp D, Cook C. Diagnostic accuracy of physical examination tests of the ankle/foot complex: a systematic review. International journal of sports physical therapy. 2013 Aug;8(4):416.