Tarsal tunnel syndrome (TTS) results from the compression of the posterior tibial nerve within the tarsal tunnel, a narrow channel on the inside of the ankle. This tunnel is covered by a thick ligament and also contains tendons, arteries, and veins. When non-surgical treatments fail to relieve pain, numbness, and tingling, tarsal tunnel release surgery is often recommended to decompress the nerve. Understanding the total time commitment involves considering the procedure, the facility stay, and the long-term healing process.
The Operating Room Procedure Duration
The actual time spent with the surgeon actively operating on the ankle is relatively short, typically ranging from 30 to 90 minutes. The procedure’s goal is to cut the thick band of tissue, known as the flexor retinaculum, to relieve pressure on the tibial nerve and its branches. This action provides more space within the tarsal tunnel, allowing the nerve to heal and improving its blood supply.
The specific duration is influenced by the surgical technique employed, primarily whether the approach is open or endoscopic. Open surgery involves a longer incision along the inner ankle, providing direct visualization of the nerve and its branches. An endoscopic procedure uses smaller incisions and a camera, potentially reducing operating time and soft tissue trauma.
Complexity also plays a role; the surgeon may need to perform additional steps beyond a simple ligament release. This could include removing scar tissue, a ganglion cyst, or another mass contributing to the nerve compression. The need to carefully identify and protect the small calcaneal nerve branches adds to the precise nature of the operation.
Total Facility Time and Immediate Recovery
The entire “door-to-door” experience for the patient on the day of surgery is significantly longer than the operating time alone, often requiring a total of four to six hours. Tarsal tunnel release is generally performed as an outpatient procedure, meaning the patient is discharged home the same day. This total time is divided into distinct pre-operative and post-operative phases.
Pre-Operative Phase
The pre-operative phase usually takes between one and two hours, beginning with check-in and administrative tasks. During this time, the patient meets with the nursing staff, the surgeon, and the anesthesiologist to review the procedure and finalize the anesthesia plan. The surgical site is marked, and an intravenous line is started.
Post-Anesthesia Care Unit (PACU)
Following the procedure, the patient is moved to the Post-Anesthesia Care Unit (PACU) for immediate recovery, which typically lasts from 1.5 to 3 hours. The medical team monitors vital signs, manages initial pain, and ensures stability before discharge. The patient receives detailed discharge instructions and a prescription for pain medication.
Post-Surgical Healing and Rehabilitation Timeline
The timeline for full recovery extends far beyond the day of surgery, as nerve healing is a gradual and individualized process that can take many months. Immediately after surgery, the ankle is placed in a dressing or splint, and patients are advised to keep the leg elevated to minimize swelling. Non-weight bearing, using crutches or a knee scooter, is common for the first one to two weeks to allow the incision to heal.
At about two weeks post-surgery, sutures are typically removed, and the patient may transition to a walking boot with partial weight bearing. The transition to full weight bearing and regular shoes is gradual, often occurring around four to six weeks, depending on wound healing progress. Physical therapy usually begins between four and six weeks, focusing on regaining ankle motion, reducing swelling, and strengthening the foot and core muscles.
Returning to daily activities is progressive; driving is often restricted for four to six weeks if the right foot was operated on. While some patients report immediate relief, maximum nerve recovery and the return to full activity often take between three and six months. For patients with long-term nerve compression and significant damage, the complete resolution of symptoms can take up to a year or 18 months.