Posterior Tibialis Teondonitis
Posterior Tibial Tendonitis: Symptoms, Causes, and Treatment Options
Posterior Tibial Tendonitis is a common condition that affects the posterior tibial tendon, which plays a crucial role in stabilizing the ankle and supporting the arch of the foot. This condition is characterized by inflammation or degeneration of the tendon, and can lead to pain and dysfunction. If left untreated, it can progress to more severe issues, including adult-acquired flatfoot problems. This blog post will provide an overview of posterior tibial tendonitis, its symptoms, causes, and available treatment options.
What is Posterior Tibial Tendonitis?
The posterior tibial tendon runs along the inside of the ankle and attaches to various structures in the foot. Its primary function is to support the arch and help the foot maintain a proper walking gait. When this tendon becomes inflamed or damaged, it can result in posterior tibial tendonitis.
Symptoms of Posterior Tibial Tendonitis
The symptoms of posterior tibial tendonitis can vary in severity but often include:
Pain along the inside of the ankle and foot: This is usually the first symptom and can range from mild to severe.
Swelling: Inflammation can cause noticeable swelling along the tendon.
Tenderness: The area may be tender to the touch.
Difficulty walking: As the condition progresses, it can become difficult to walk or stand for extended periods.
Flatfoot: In advanced cases, the arch of the foot may collapse, leading to a flatfoot deformity.
Causes of Posterior Tibial Tendonitis
Several factors can contribute to the development of posterior tibial tendonitis, including:
Overuse: Activities that put repetitive stress on the tendon, such as running, hiking, or standing for long periods, can lead to overuse injuries. (also ramping up running volume too quickly can cause this problem!)
Trauma: Acute injuries, such as ankle sprains, can damage the posterior tibial tendon.
Age: Degeneration of the tendon can occur with age, making older adults more susceptible.
Inflammatory diseases: Conditions such as rheumatoid arthritis can increase the risk of developing tendonitis.
Diagnosis
Diagnosing posterior tibial tendonitis typically involves a physical examination and an assessment of your symptoms. Our team will perform specific tests to evaluate the function of the tendon. Imaging studies, such as X-rays, MRI, or ultrasound, may be used to confirm the diagnosis and rule out other conditions.
Treatment Options
Treatment for posterior tibial tendonitis aims to reduce pain, inflammation, and prevent further damage to the tendon. Depending on the severity of the condition, treatment options may include:
Non-Surgical Treatments (60% of the time!)
Rest and Activity Modification: Reducing or avoiding activities that exacerbate the symptoms can help alleviate pain and inflammation.
Ice Therapy: Applying ice packs to the affected area can reduce swelling and provide pain relief.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.
Orthotics: Custom orthotic devices can provide support to the arch and help distribute pressure more evenly across the foot.
Physical Therapy: Stretching and strengthening exercises can improve the function of the posterior tibial tendon and the surrounding muscles.
Bracing: In some cases, a brace or walking boot may be recommended to immobilize the foot and allow the tendon to heal.
Surgical Treatments
If non-surgical treatments are not effective, or if the condition has progressed to a severe stage, surgery may be necessary. Surgical options can include:
Tendon Debridement: Removal of damaged tissue to allow healthy tissue to regenerate.
Tendon Transfer: Using a healthy tendon from another part of the foot to replace the damaged posterior tibial tendon.
Osteotomy: Realignment of the bones in the foot to improve the function of the tendon and restore the arch.
Arthrodesis: Fusion of the affected joints to stabilize the foot and reduce pain.
Prevention
While it may not be possible to prevent all cases of posterior tibial tendonitis, certain measures can help reduce the risk:
Wear appropriate footwear: Supportive shoes with good arch support can help prevent overuse injuries.
Avoid high-impact activities: Limiting activities that put excessive stress on the tendon can reduce the risk of developing tendonitis.
Strengthening exercises and ramping exercise volume gradually:: Regular exercises to strengthen the muscles of the lower leg and foot can improve the stability and function of the posterior tibial tendon. Ramping up your running or walking volume PROGRESSIVELY is an easy way to avoid trouble with the Posterior Tib Tendon.
Conclusion
Posterior tibial tendonitis is a common but manageable condition that can significantly impact your quality of life if left untreated. Early diagnosis and appropriate treatment are crucial to preventing progression and reducing symptoms. If you experience persistent pain along the inside of your ankle or foot, our office is here to help and can perform a comprehensive evaluation and create a tailored treatment plan. By understanding the symptoms, causes, and treatment options for posterior tibial tendonitis, you can take proactive steps to maintain healthy, pain-free feet.
