Posterior Tibial Tendonitis

Tendonitis is a common foot problem as our feet take tremendous amounts of stress and rarely get to rest. The Posterior Tibial Tendon is particularly prone to problems as it must work constantly to support the arch of the foot.

If you think you may have posterior tibial tendonitis make an appointment right away to see us in our Seattle clinic. If not treated, this tendonitis can lead to a rupture or tear of the tendon.

Anatomy
The posterior tibial tendon starts deep in the calf and runs behind the ankle bone on the inside of the ankle. The tendon continues along towards the foot and attaches into multiple locations on the inside and the bottom of the arch. A tremendous amount of tension and stress is placed is on this tendon with every step as it helps to maintain and recreate the arch of the foot. The amount of stress on the tendon varies from person to person depending on the shape of their foot (flatfeet versus a very high arch). It would seem that only a flatfooted person would get posterior tibial tendonitis is more common in flatfooted people, but it can occur in anyone.

Figure 1 - Posterior Tibial Tendon

Symptoms
Symptoms of posterior tibial tendonitis include pain and swelling along the inside of the ankle and arch along the course of the tendon. Pain is present with walking, exercise or just standing. This discomfort will usually increase over time. This pain initially is absent when at rest but may progress to the point where pain is present even when not active. In advanced cases the injury to the tendon that started as tendonitis may result in a full or partial tear of the tendon.

Figure 2 - Flattening of your foot causes outward rotation of heel promoting Posterior Tibial Tendonitis

Diagnosis
We can usually make this diagnosis very easily by history and examination. Sometimes we will order an MRI or ultrasound to determine the extent of damage to the posterior tibial tendon.

Initial Treatment
Treatment can depend on how long the symptoms have been present and the amount of strength that is lost (if any) in the tendon. Initial treatment may include:

• Anti-inflammatory medication
• Orthotics
• Physical therapy,
• Rest

Orthotics for Posterior Tibial Tendonitis
Orthotics for this problem are designed specifically to reduce tension on the posterior tibial tendon. This often requires an orthotic that is deeper than normal around the heel and perfectly matches the arch of the foot (total contact orthotics). The correct orthotic can not only help heal the tendon by reducing tension on it but can also help prevent reoccurrence of the problem.

Treatment for Resistant Cases
This problem should be treated as early as possible in order to prevent damage to the tendon that can be more difficult to treat. Call us at our Seattle clinic right away if you are having symptoms.

In more severe cases a cast from the knee down may be utilized from four to six weeks to allow the tendon to completely rest without placing the day-to-day demands of walking on it. If these measures fail to produce acceptable results surgical intervention may be necessary to clean around the tendon and repair any defects in the tendon. Surgical repair is more commonly needed when there is a progressive weakness in the tendon. This loss of strength is called posterior tibial tendon dysfunction.

 

WEBSITE DISCLAIMER
For website errors ONLY email webmaster at WEBMASTER
All pages on this website © 2005-2010
Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
The material provided on this web site is for informative purposes only.
If you need specific medical advice, please contact the office for an appointment.

Free

Recommended Shoes List

To download our Shoe List, subcribe to our foot health newsletter.

Email: