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Posterior Tibial Tendonitis

What is posterior tibial tendonitis, and how is it treated?

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Topic at a Glance

  • Posterior tibial tendonitis is a common foot and ankle problem.
  • It can be caused by repetitive wear and tear or injury.
  • If left untreated, it can lead to adult-acquired flatfoot or tendon rupture.
  • Early treatments include conservative measures, with surgery as an option in some cases.

Posterior tibial tendonitis (also known as posterior tendon dysfunction) is a common foot and ankle problem. Posterior tibial tendonitis occurs when the posterior tibial tendon, located in the foot, becomes irritated due to overuse, injury, or inflammation.

Discover how OrthoNeuro’s foot and ankle specialists in Columbus, Ohio, can diagnose and treat complex conditions like posterior tibial tendonitis and adult-acquired flatfoot deformity with personalized care. Contact us today to schedule a consultation.

About Posterior Tibial Tendonitis

Posterior tibial tendonitis is a painful condition that usually causes foot and ankle pain and discomfort during daily activities. In addition, it may result in adult-acquired flat foot deformity due to the inability of the posterior tibial tendon to provide support and stability for the foot’s arch. Other possible complications include a partial or complete rupture of the tendon.

Anatomy of the Posterior Tibialis Tendon

The posterior tibial tendon plays an important role in foot function and stability. A tendon (strong cord-like tissue) attaches muscles to bones. The posterior tibial tendon attaches the calf muscle (tibialis posterior muscle) to the bones in the foot.

The posterior tibial tendon extends from the calf down to the inside of the ankle and the bones of the foot. The posterior tibial tendon is important for walking as it supports the arch of the foot.

What Causes Posterior Tibial Tendonitis?

Posterior tibial tendinitis is often caused by repetitive use and wear of the tendon over extended periods of activity. This condition is common in people with obesity as well as those who participate in sports that involve a high impact on the ankle and foot, such as dancing, basketball, soccer, and tennis.

The Symptoms of Posterior Tibial Tendon Dysfunction

The signs and symptoms of posterior tibial tendonitis are:

  • Swelling in the ankle
  • Weakness in the foot
  • Pain on the inside of the foot and ankle bone (medial malleolus)
  • Spasms of the peroneal tendons on the outside of the foot
  • A gradual flattening of the arch of the foot (a flat foot)
  • Pain in the tarsal tunnel (similar to carpal tunnel in the hand)
  • Difficulty walking or running

When to See a Doctor

If you have the symptoms mentioned above, it is important to see your doctor. If left untreated, posterior tibial tendon problems can lead to progressive collapsing foot deformity.

As the condition progresses, the arch in the foot begins to flatten, which causes more pain. A flattened arch may also cause damage to nearby structures inside the ankle, such as the deltoid ligament. The joints can also become misaligned, leading to ankle arthritis.

How is Posterior Tibial Tendonitis Diagnosed?

A foot and ankle specialist usually makes the diagnosis of tibial tendonitis. To diagnose this condition, the specialist will ask about your medical history and your level of physical activity.

  • The specialist will then conduct a physical examination looking for swelling in the ankle, tenderness in the tendon, stiffness, and signs of deformity in the ankle and foot.

Your healthcare provider might also ask you to stand on your toes (single-limb heel-rise) to see if you have lost the arch of your foot. To confirm a diagnosis of tibial tendonitis, a doctor will also take imaging tests such as X-rays and MRIs.

What is the Treatment for Posterior Tibial Tendonitis?

Most patients can be treated for posterior tibial tendonitis without surgery using foot braces and orthotics. Non-surgical treatments are usually used with patients who are in the early stages of posterior tibial tendon degeneration. Posterior tibial tendon dysfunction usually takes around 6 to 8 weeks to recover fully.

The non-surgical treatment methods used for tibial tendonitis include:

  • Limiting activities that place stress on the ankle or foot, such as sports
  • Severe cases may require wearing a protective boot for a few weeks
  • Applying ice to the foot
  • Elevating the foot to reduce swelling
  • Taking over-the-counter medications such as ibuprofen
  • Physical therapy to strengthen the posterior tendon through targeted exercises
  • Orthotics and supportive shoes for arch support, which allow the tendon to heal

Surgical treatment is usually recommended for patients with advanced stages of posterior tibial tendon dysfunction or those who haven’t recovered using conservative treatments within six months.

There are several surgical options depending on how far the condition has progressed:

  • Tenosynovectomy: During this procedure, foot and ankle surgeons remove inflamed or torn tissue from the foot.
  • Tendon Transfer: This procedure replaces the damaged posterior tibial tendon with a healthy tendon transfer from the foot.
  • Achilles Tendon Lengthening: Achilles tendon lengthening is another surgical procedure that may be recommended to treat adult-acquired flat foot.
  • Osteotomy: In more advanced cases of tibial tendonitis, a foot and ankle surgeon may realign the foot by fusing the joints using plates and screws.

You will need to see a physical therapist following any surgical procedure for rehabilitation.

Make an Appointment with an OrthoNeuro Specialist Today!

If you have been suffering the symptoms of posterior tendon dysfunction, schedule an appointment with one of our board-certified foot and ankle specialists at OrthoNeuro. We have many convenient locations throughout Greater Columbus.

Medically reviewed by Scott Smith, MD

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Related Services

Foot & Ankle

Podiatry

FAQs About Posterior Tibial Tendonitis

Yes. When the posterior tibial tendon becomes damaged or weakened, it may no longer provide adequate support for the arch of the foot, potentially leading to adult-acquired flatfoot deformity.

Activities that place repeated stress on the foot and ankle, such as sports that involve running, can aggravate symptoms and contribute to tendon irritation.

Recovery times vary depending on the severity of the condition. Many patients begin improving within 6 to 8 weeks with conservative treatment, although some cases may take several months to fully recover.

Yes. Many patients respond well to non-surgical treatments. These may include rest, activity modification, physical therapy, orthotics, foot braces, and anti-inflammatory medications.

Without treatment, the condition can progressively worsen, causing the arch to collapse, changes in foot alignment, and potentially leading to arthritis and other complications in the foot and ankle.

Foot, Ankle, and Podiatry Specialists

IF YOU HAVE AN ACUTE INJURY OR LIVE WITH CHRONIC FOOT AND ANKLE PAIN IN CALL ORTHONEURO TODAY OR MAKE AN APPOINTMENT ONLINE FOR EXPERT FOOT AND ANKLE CARE IN COLUMBUS, OHIO.

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