Definition
Posterior Tibial Tendinitis is an inflammation of the posterior tibial tendon and its sheath. It affects this tendon as it runs from the inside of the ankle to the arch of the foot.
Tendons are fibrous cords that connect muscles to bones. The Posterior Tibial Tendinitis helps maintain the arch of the foot and is used to turn the foot in and to help flex it. Injury to this tendon can result in loss of function, primarily affecting push off from the ground with walking and running.
Causes
The
Posterior Tibialis Tendon can become inflamed for several reasons.
These include:
- Injury, due to:
- Too much running, dancing, or other athletic activity
- Trauma with high impact
- Pronation, which is walking on the inner aspect of the foot.
Walking this way alters the normal forces in the feet—the arch flattens and
the ankle tilts inward. To compensate, the muscles work harder and become
tired. This may lead to chronic inflammation of the tendon. Long term, it can
cause the tendon to deteriorate, lengthen, and even completely rupture. If
that happens, the foot flattens. This condition is called flatfoot deformity.
- Aging. With age, the posterior tibial muscle and tendon may become
weaker and cause flattening of the arch. This puts further stress on the
tendon. Other foot conditions may contribute to loss of the arch over time.
- Chronic inflammation, associated with rheumatoid arthritis or other
arthritic conditions.
Risk Factors
A risk factor is something that increases your chances of getting a disease
or condition. Risk factors for
Posterior Tibial Tendinitis include:
- History of rheumatoid arthritis or other arthritic conditions
- Running
- Dancing, for example ballet pointe work and excessive foot rotation
- Pronated feet
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a
physical exam, paying special attention to the foot.
Posterior Tibialis
Tendinitis can be difficult to diagnose because pain in the ankle and foot
can be due to many causes.
The doctor will try to feel the tendon through your skin and note how the foot
moves and handles resistance to moving the foot inwards. He or she will look at
the foot from behind and from the side and see how flat the arch is. The doctor
may also ask you to try to stand on the ball of your foot.
Tests may include:
- X-rays – a test that uses radiation to take a picture of structures inside
the body, in this case the foot and leg.
- MRI scan – a test that uses magnetic waves to make pictures of the inside
of the body, in this case looking at the posterior tibial tendon.
Treatment
The goals of treatment are to:
- Prevent the foot from pronating
- Decrease inflammation and prevent deterioration of the tendon
You may be referred to an orthopedic specialist. Early treatment and
correction of the underlying cause improves the prognosis. Treatment may
include:
- Rest
- Strapping or taping the foot; some people need a cast or a brace
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Cortisone injection into the tendon sheath, although multiple injections
may further damage the tendon
- Physical therapy, including:
- Exercises to strengthen the posterior tibial muscle
- Correction of poor dance or exercise techniques
- Custom-made orthotics – these are shoe inserts that can decrease tension
on the tendon and support the foot
- Surgery to repair the tendon
Prevention
To help prevent
Posterior Tibialis Tendinitis, practice good foot
care. This includes:
- If you notice you are walking on the inner aspect of your foot, consult a
doctor
- If you have a foot or ankle injury, get medical care
- Wear good, supportive shoes that provide arch support
- Obtain proper training for sports and dance activities