Recovery from tarsal tunnel surgery is a gradual process that typically takes 6 to 12 months to reach full improvement, though most people return to daily activities around the 6-week mark. The first few weeks focus on protecting the surgical site, followed by a slow transition back to weight bearing and eventually strengthening exercises. Here’s what the process looks like from the day of surgery through long-term healing.
The First Few Days After Surgery
Your foot will be placed in a post-operative dressing and splint before you leave the surgical facility. For the first five days, keep your ankle elevated above heart level as much as possible. After that, continue elevating when you notice swelling or discomfort, up to about two weeks out.
Icing is one of the most effective things you can do early on. Apply an ice pack for 20 to 25 minutes every one to two hours during the first 48 to 96 hours. Place a towel or thin shirt between the ice and your skin to prevent frostbite. After those initial days, continue icing as needed when pain or swelling flares up.
Pain is usually most intense in the first 72 hours, then steadily decreases. Your surgeon will provide a pain management plan for this window. Expect the foot to look swollen and bruised, which is normal.
Weight Bearing and Getting Around
You won’t be walking normally right away. After surgery, you’ll be limited to touch-down weight bearing in a fracture boot, meaning you can lightly place your foot on the ground for balance but shouldn’t put your full body weight through it. This protects the incision while it heals.
Stitches come out around 2 to 3 weeks after surgery. Once your surgeon removes them, you’ll get specific guidance on transitioning to full weight bearing. For most people, returning to normal daily activities without assistive devices happens around the 6-week mark, though more physically demanding cases can take longer. Expect to use crutches or a walker during those early weeks.
What Your Nerves Feel Like During Healing
Tarsal tunnel surgery works by releasing pressure on the tibial nerve, and that nerve needs time to recover. In the weeks and months after surgery, you may experience tingling, buzzing, mild electric sensations, or patches of numbness in your foot. These sensations can feel alarming, but they’re a normal part of nerve healing and generally signal that the nerve is waking back up.
Some people develop temporary hypersensitivity along the inner side of the foot, where even light touch feels uncomfortable or sharp. This typically fades over time as the nerve settles. The key distinction to watch for is whether symptoms are gradually improving or getting progressively worse. A slow, uneven recovery with good days and bad days is normal. Symptoms that intensify significantly weeks after surgery warrant a call to your surgeon.
The Rehabilitation Process
Physical therapy plays a major role in recovery and generally follows three phases.
During the first 1 to 3 weeks, a therapist may begin gentle passive movements of your toes and ankle. You won’t be doing these yourself. The goal is to prevent the tendons that run through the tarsal tunnel from stiffening up while the incision heals.
From weeks 3 to 6, rehabilitation ramps up. You’ll start doing gentle ankle stretches, first with assistance (like using a towel or strap to stretch the top of your foot toward you), then on your own. Your therapist will also introduce nerve gliding exercises, which are specific movements designed to help the tibial nerve slide freely through the surrounding tissue without getting stuck in scar tissue. These start gently and progress as your irritability decreases. Light weight-bearing stretches begin during this phase as well.
From weeks 6 through 12 (and sometimes up to 24), the focus shifts to rebuilding strength. You’ll use resistance bands for ankle exercises, then progress to body-weight exercises like calf raises and standing on an incline. Stretching continues throughout. This phase is where you regain the functional strength needed for walking long distances, climbing stairs, and eventually returning to exercise or sport.
The Longer Recovery: 6 to 12 Months
Even after you’re walking comfortably and done with formal rehab, nerve healing continues. Most people notice continued improvement for 6 to 12 months after surgery. This is normal. Nerves regenerate slowly, roughly a millimeter per day, so sensations in the sole of your foot may keep changing well after the incision has fully healed.
Some weeks you’ll feel noticeably better, and others you’ll wonder if something went wrong. This uneven pattern is typical of nerve recovery. The overall trend matters more than any single day. Many patients report that they didn’t feel truly “back to normal” until somewhere between 6 and 12 months post-surgery, when residual swelling, sensitivity, and stiffness finally resolve.
How Likely Is the Surgery to Help?
A study of 81 patients followed for at least 18 months after tarsal tunnel release found that about 90% reported good or excellent results, with roughly 77% achieving complete or near-complete symptom resolution. About 10% of patients in that study did not improve meaningfully.
Those numbers reflect a broader reality: tarsal tunnel surgery helps most people, but outcomes aren’t guaranteed. Some patients experience significant relief within weeks, while others improve slowly over many months. Factors that influence results include how long you had symptoms before surgery, whether the nerve sustained permanent damage, and the underlying cause of the compression. People who had surgery after years of severe symptoms tend to have less complete recovery than those treated earlier.
Possible Complications
The most common complications are delayed wound healing and scar formation around the surgical site. Infection is possible but uncommon with proper wound care. The incision runs along the inner ankle, an area that moves frequently, so following your surgeon’s instructions about keeping the site clean and dry matters.
Scar tissue is a particular concern with tarsal tunnel surgery because new scar tissue can form around the nerve and recreate the compression the surgery was meant to fix. This is one reason nerve gliding exercises during rehab are so important: they help the nerve move independently of the surrounding tissue as it heals.
Some patients find that pain and numbness don’t fully resolve even after successful decompression. Relapse is possible, and certain people experience a cycle of improvement and recurrence. The overall prognosis depends heavily on individual factors, but going into surgery with realistic expectations helps. For many people, the goal is substantial improvement rather than a perfectly symptom-free foot.