Fibularis syndrome - anterior tarsal tunnel syndrome

Fibularis syndrome - anterior tarsal tunnel syndrome

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In the course of our lives, our feet will probably walk around 160,000 kilometers, i.e. four marches along the equator around the earth. It is important that their function is guaranteed so that they can always move around well. Difficulty walking 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 considerable limitation here.


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

Discomfort and symptoms

Usually there is a lack of coordination of the feet and disturbances in the sensitivity of the big and the second toe, which in turn can cause difficulty walking. In addition, there is often muscle weakness in the foot and also in the calf. Complaints can often be triggered by pressing the constricting area or e.g. wearing shoes that are too tight. This facilitates a meaningful diagnosis and often treatment at the same time.

Causes of Anterior Tarsal Tunnel Syndrome

In medicine, the fibularis syndrome is also called the "anterior tarsal tunnel syndrome". This results in the deep branch of the common fibular nerve, the deep fibular nerve (previously: deep peroneal nerve) being pinched off. Its fibers originate from the 4th lumbar vertebra (L4) to the first sacrum (S1) and supply the extensor muscles of the calf and the skin between the big toe and the second toe.

The nerve runs deep along the shin and can be pinched off at the forefoot by a band that runs across the foot above the instep. Just like with the (posterior) tarsal tunnel syndrome, the cause is assumed to be a previous injury or illness, which can then lead to narrowing due to bruising or swelling of the tissue. Anterior tarsal tunnel syndrome can also occur during pregnancy, menopause or hormone disorders. 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 gluteus muscle, the piriformis muscle. Some authors, like the French expert in osteopathy Jean Pierre Barral, also point out the possibility of compression on the fibula head, where the nerve runs very closely. A fracture of the fibula head or hardening could result in a pinch off. (tf, fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch


  • Professional association for orthopedics and trauma surgery e. V .: Tarsal tunnel syndrome (accessed: August 13, 2019), orthinform.de
  • Tarsal tunnel syndrome (posterior tibial neuralgia) (accessed: August 13, 2019), msdmanuals.com
  • Ruchholtz, Steffen / Wirtz, Dieter Christian: Orthopedics and trauma surgery essentials: Intensive course for further training, Thieme, 3rd edition, 2019
  • Austria's public health portal: Tarsal tunnel syndrome (accessed: 13.08.2019), gesundheit.gv.at
  • National Organization for Rare Disorders (NORD): Tarsal Tunnel Syndrome (accessed: August 13, 2019), rarediseases.org
  • University Clinic Hamburg-Eppendorf (UKE): Tarsal tunnel syndrome (accessed: August 13, 2019), uke.de

ICD codes for this disease: G57ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.

Video: Tarsal Tunnel Syndrome - Michael Lai, DPM (October 2022).