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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
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Abstract

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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

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