Posterior Tibial Tendonitis

Posterior tibial tendonitis, also known as posterior tibial tendon dysfunction (PTTD), is a condition characterized by inflammation and irritation of the posterior tibial tendon.

This tendon plays a crucial role in supporting the arch of the foot and stabilizing the ankle during walking. Here’s an overview of the symptoms, causes, diagnosis, and treatment of posterior tibial tendonitis:

Symptoms

The symptoms of posterior tibial tendonitis may vary in severity and can include:

1. Pain and swelling: Pain and swelling along the inside of the ankle or foot, typically around the medial (inner) side of the foot arch.

2. Difficulty with foot movement: People may experience difficulty moving the foot and have trouble standing on their toes or performing other weight-bearing activities.

3. Flatfoot deformity: PTTD can lead to the gradual flattening of the arch of the foot, causing the foot to roll inward (pronation).

4. Tenderness: Tenderness may be present along the course of the posterior tibial tendon, particularly where it inserts into the bones of the foot and ankle.

5. Weakness: Weakness in the affected foot and ankle may be noticeable.

Causes

The exact cause of posterior tibial tendonitis is not always clear, but several factors can contribute to its development, including:

1. Overuse or repetitive stress: Engaging in activities that put excessive strain on the posterior tibial tendon, such as running, jumping, or dancing, can lead to inflammation and tendonitis.

2. Age-related degeneration: Tendons naturally weaken and become more prone to injury with age, which can contribute to the development of PTTD.

3. Foot structure: Individuals with flat feet or high arches may have an increased risk of developing posterior tibial tendonitis.

4. Injury: A direct injury or trauma to the foot or ankle can lead to inflammation of the posterior tibial tendon.

5. Inflammatory conditions: Certain inflammatory conditions, such as rheumatoid arthritis, can affect the tendons, including the posterior tibial tendon.

Diagnosis

Diagnosing posterior tibial tendonitis typically involves a thorough evaluation by a healthcare professional, often an orthopedic specialist or a foot and ankle specialist. The diagnostic process may include:

1. Medical history: The doctor will inquire about symptoms, previous injuries, and activities that may contribute to the condition.

2. Physical examination: The foot and ankle will be examined for signs of swelling, tenderness, and changes in foot structure.

3. Gait analysis: Observing how the patient walks can help identify abnormalities in foot movement.

4. Imaging tests: X-rays or MRI scans may be ordered to assess the bones, soft tissues, and alignment of the foot and ankle.

Treatment

The treatment of posterior tibial tendonitis aims to reduce inflammation, alleviate symptoms, and restore normal foot function.

Treatment options may include:

1. Rest and activity modification: Reducing or avoiding activities that aggravate the condition can allow the tendon to heal.

2. Immobilization: Wearing a walking boot,  ankle brace or cast can help rest the affected foot and reduce strain on the tendon.

3. Physical therapy: A physical therapist can design a program to strengthen the muscles around the foot and ankle, improve flexibility, and correct foot mechanics.

4. Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen or naproxen may be used to reduce pain and inflammation.

5. Orthotics: Custom orthotic inserts can help support the foot arch and reduce stress on the posterior tibial tendon.

6. Ice therapy: Applying ice to the affected area can help reduce swelling and pain.

7. Corticosteroid injections: In some cases, a doctor may recommend injecting corticosteroids into the tendon to reduce inflammation and pain.

8. Surgery: If conservative treatments do not provide relief, surgical intervention may be considered to repair or reconstruct the posterior tibial tendon.

It’s essential to seek early medical evaluation and treatment for posterior tibial tendonitis to prevent the condition from progressing and potentially causing long-term complications.

Following the prescribed treatment plan and taking measures to prevent overuse and excessive stress on the foot can promote a successful recovery and help maintain foot health.