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Posterior Tibial Tendon Dysfunction

What is posterior tibial tendonitis?


The Posterior Tibial Tendon is a long tendon that runs from the leg to the inside of the ankle and arch.  It pulls the foot into a higher arch position with walking and running.  It is a major supporting structure of the foot.  Over straining, usually due to abnormal biomechanics, can cause arch pain with increased activity.


Posterior tibial tendon dysfunction is a condition caused by changes or degeneration within the tendon itself, impairing its ability to support the arch. This results in flattening of the foot.

This condition is usually progressive, but can also come on rather quickly.  If so, then aggressive treatment should be sought sooner than later. If left untreated, it could leave you with an extremely flat foot, painful arthritis, and increase limitations with physical activity.


Symptoms:

Flattening of the arch, inward rolling of the ankle, pain, swelling, etc


Treatment and Prevention:


Rest may help but it is usually best to obtain an aggressive supportive orthotic to address the cause.   In severe cases, some may be placed in an ankle foot orthotic (afo).  However, I have found afo’s to be bulky, causing you to obtain larger shoes. Also, most are made like a brace, eliminating muscular function leading to atrophy.  In most cases, functional foot orthotics should be the first line of choice.

image528

Example of where the posterior tibial tendon is inflamed.

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