What is Posterior Tibial Tendonitis?
Tendonitis is a common condition developed in the foot due to continuous use on a daily basis. The posterior tibial tendon, which helps to maintain the arch of the foot and prevent excessive flattening of the foot while walking, standing, or running is especially prone to tendonitis. This tendon starts in the deep portion of the calf and runs behind the prominent bone on the inside of the ankle and inserts into multiple locations on the inside and bottom of the arch. Posterior tibial tendonitis can be a precursor to posterior tibial tendon dysfunction, a condition that involves the progressive loss of strength in the tendon and progressive flattening of the arch.
What is Posterior Tibial Tendonitis
Symptoms include pain and swelling along the inside of the ankle and foot arch during exercise and extended periods of walking or standing. Initially, pain is absent when at rest but as the disease progresses pain intensifies even when you are not active. The swelling that you see and feel on the inside of the ankle is a result of the sheath surrounding the tendon producing excessive amounts of lubricating fluid in an attempt to allow the tendon to glide easily during the healing process. In advanced or untreated cases the injury to the tendon can progress from tendonitis into a partial or full tear of the tendon.
Your podiatrist can often diagnose posterior tibial tendonitis by reviewing your history and physical exam. In many instances a MRI or ultrasound will be performed to determine the extent of damage done to the posterior tibial tendon. Your foot doctor may also have you stand on the tips of your toes on each foot to gauge the strength of each tendon.
Treatment depends on how long the symptoms have been present and the extent of the damage to the tendon. Non-steroidal anti-inflammatory medication, physical therapy, rest and orthodics are often first course of action. Cortisone injections are performed on rare occasions and are often accompanied by cast immobilization. These treatments are directed towards decreasing stress placed on the tendon therefore reducing inflammation. In severe cases an immobilization cast may be used for a four to six week period in order to eliminate any type of stress applied to the tendon to allow for complete rest. Surgical intervention may be necessary if swelling is still present after these procedures in order to clean the area around the tendon and repair any defects. Surgical repair however, is more common when there is a progressive weakness in the tendon (posterior tibial tendon dysfunction).
Metroplex Foot and Ankle is a progressive group of physicians and surgeons who are committed to helping our patients to achieve their full wellness potential. Contact our Dallas Podiatrist, Garland Podiatrist, or Richardson Podiatrist offices to schedule an appointment today.