Posterior Tibial Tendonitis

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, gets torn or inflamed.

Posterior tibial tendonitis usually causes pain in the foot and ankle. In addition, it may result in adult acquired flat foot deformity because of the inability of the posterior tibial tendon to provide support and stability for the arch of the foot.

If you are experiencing pain in your ankle or foot that interferes with mobility, then schedule a consultation with the team at OrthoNeuro.

Our orthopedic surgeons provide state-of-the-art diagnosis and personalized treatment. So call or book an appointment now.

Anatomy of the Posterior Tibialis Tendon

The posterior tibial tendon is an important tendon in the leg. A tendon (strong cord-like tissue) attaches muscles to bones. The posterior tibial tendon attaches the calf 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 stability and arch of the foot.

What Causes Posterior Tibial Tendonitis?

Tibial tendonitis is often caused by repetitive use of the posterior tibial tendon.

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.

Posterior Tibial Tendonitis Symptoms

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. Posterior tibial tendon dysfunction can get progressively worse if untreated. 

As the condition progresses, the arch in the foot begins to flatten, which causes more pain.

A flattened arch may also cause the ligaments inside the ankle to stretch and the joints to 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 your tendon, stiffness, and signs of deformity to your 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
• 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
• Orthotics and foot braces to support the tendon and allow it 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.

Posterior tibialis tendon surgery involves foot and ankle surgeons removing inflamed or torn tissue from the foot.

Then, another procedure replaces the damaged posterior tibial tendon with a healthy tendon transfer from the foot. 

With more advanced cases of tibial tendonitis, a foot and ankle surgeon may realign the foot by fusing the joints in the foot together using plates and screws.

Conclusion

If you have pain in the ankle or foot and want to know if you have posterior tibial tendon insufficiency, schedule a consultation online today at OrthoNeuro. 

Our orthopedic surgeons provide state-of-the-art diagnosis and personalized treatment.