Posterior tibial tendonitis is defined as inflammation of the posterior tibial muscle tendon. The posterior tibial tendon runs along the inside part of your ankle and attaches to a bone in your foot known as the navicular. This muscle aids in supporting your arch and is also the strongest supinator of the foot, which means it helps your foot turn inward while running. Posterior tibial tendonitis can be seen in runners due to the constant work load that the muscle must perform in propelling the foot forward. It is also common to see this problem in runners with flat feet or who over-pronate due to the increased stretching of the tendon. Posterior tibial tendonitis occurs in stages: first the covering or sheath of the tendon becomes irritated. Second, with increased use and age (wear and tear), the tendon which is comprised of collagen fibers will degenerate leading to scar tissue formation and inflammation.
Symptoms:
Typical symptoms include pain in the instep of your arch and swelling along the tendon.
Diagnosis:
Your doctor will likely diagnose you with posterior tibial tendonitis clinically in the office, confirmation or further evaluation may require an MRI.
Treatment:
Conservative options for treatment of posterior tibial tendonitis in order to get you back to running and exercising include:
- Custom Molded Orthoses (CMO’s) which relieve pain and stress along the tendon by taking tension off and providing an appropriate arch for your foot
- Anti-inflammatory drugs such as Ibuprofen or medrol
- Immobilization in a brace or boot walker
- Laser treatment to reduce inflammation and assist with tendon healing
- Physical therapy
- Ankle foot orthosis (AFO)
Sometimes surgical intervention is necessary in cases of protracted symptoms or if a tendon tear or degeneration is present. In most cases early conservative treatment may reduce the need for surgery, so don’t ignore these symptoms if you have this condition.
Please contact us if you are experiencing pain due to this condition-we’re here to help!