okay this is a patient who's had a tarsal tunnel injection in the past she had a tibial nerve block at the tarsal tunnel which helped her a lot with her pain it's been about 6 months and the pain is returned she's here for a repeat injection tarsal tunnel syndrome is basically the carpal tunnel of the foot the Taral tunnel consists of the tibialis posterior tendon which is anterior followed by the flexor digitorum uh longest tendon and then behind the artery it's the flexus halis longest tendon and the nerve is next to the artery and the flexor retinaculum is shown when I scan between the malis and the calcinus and it's the soft tissue above the blood vessel and the nerves so I'm going go a little distal and make room for my needle so to do this shot I'm going to have to hydro dissect a little bit to get enough room for my needle between the bone and the target tissues and go slightly at an angle little pinch I okay anything shoot to the toes let me know and I'm in the tunnel now I'm injecting around the artery the nerve is next to the artery and we're done
