Posterior Tibial Tendonitis

What is posterior tibial tendonitis?

Running legsThe posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior Tibial Tendon Dysfunction (PTTD) is often called adult acquired flatfoot. Although this condition typically occurs in only one foot, some people may develop it in both feet. Overuse of the posterior tibial tendon is often the cause, in fact, the symptoms usually occur after activities that involve the tendon, such as running, walking, hiking, or climbing stairs. Symptoms may include pain, swelling, a flattening of the arch and an inward rolling of the ankle. As the condition progresses, the pain may change and other deformities may appear in the foot. After the tendon has deteriorated significantly, arthritis may develop in the foot or ankle. This condition is usually progressive, which means it will get worse if not treated.

How a podiatric physician can help…

Because of the progressive nature of PTTD, early treatment is advised. If treated early enough, symptoms may resolve without the need for surgery and progression of the condition can be arrested. In many cases, treatment can begin with non-surgical approaches that may include:

  • Orthotic devices or bracing. To give your arch the support it needs, your podiatric physician may provide you with an ankle brace or a custom orthotic device that fits into the shoe.
  • Immobilization. Sometimes a short-leg cast or boot is worn to immobilize the foot and allow the tendon to heal, or you may need to completely avoid all weight-bearing for a while.
  • Physical therapy. Ultrasound therapy and exercises may help rehabilitate the tendon and muscle following immobilization.
  • Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.
  • Shoe modifications. Your podiatric physician suggest special inserts designed to improve arch support in your shoes.
  • Surgery: In cases of PTTD that have progressed substantially or have failed to improve with non-surgical treatment, surgery may be required.

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Source: American College of Foot and Ankle Surgeons