Posterior Tibial Tendonitis: Causes, Symptoms & Treatment Options

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Posterior Tibial Tendonitis

Posterior tibial tendonitis is a condition that affects the tendon located on the inside of the ankle and foot. It occurs when this tendon becomes inflamed or injured, leading to pain and discomfort. In this article, we will cover various aspects of posterior tibial tendonitis, including its overview, symptoms, causes, diagnosis, tests, management, treatment, and prevention strategies. Our aim is to provide you with comprehensive information about this condition so that you can better understand it and make informed decisions regarding your health. Keep reading to learn more!

Posterior Tibialis Muscle

Overview

Posterior tibial tendonitis is a condition that affects the posterior tibial tendon, which is responsible for supporting the arch of the foot. When this tendon becomes inflamed or irritated, it can lead to pain and discomfort in the inner side of the ankle and foot.

There are several factors that can contribute to the development of posterior tibial tendonitis. One of the main causes is overuse or repetitive strain on the tendon. This can occur due to activities that involve excessive walking, running, or jumping, especially on hard surfaces. Additionally, individuals who have flat feet may be more prone to developing this condition.

People who are involved in activities that put a lot of stress on the feet, such as athletes and dancers, are also at a higher risk for posterior tibial tendonitis. Age can also be a factor, as the tendon tends to weaken and become less flexible with age, making it more susceptible to injury.

Symptoms and Causes

Posterior tibial tendonitis is a condition that affects the posterior tibial tendon, which runs along the inside of the ankle and foot. It is commonly caused by overuse or repetitive strain on the tendon, leading to inflammation and pain. Understanding the symptoms and causes of posterior tibial tendonitis is crucial for accurate diagnosis and appropriate treatment.

Common symptoms of posterior tibial tendonitis include:

• Pain and swelling along the inside of the ankle and foot
• Tenderness to touch
• Difficulty walking or standing for prolonged periods
• Weakness or instability in the affected foot
• Arch collapse or flatfoot deformity

These symptoms can vary in severity, with some individuals experiencing mild discomfort while others may have significant pain and functional limitations.

The causes and risk factors of posterior tibial tendonitis are typically related to overuse or biomechanical issues. Overuse can occur due to activities that involve repetitive or excessive stress on the tendon, such as running, dancing, or participating in sports. Biomechanical factors, such as flat feet or abnormal foot alignment, can also contribute to the development of tendonitis.

Differentiating posterior tibial tendonitis from other foot conditions is important to ensure proper treatment. Conditions that may have similar symptoms include plantar fasciitis, Achilles tendonitis, or stress fractures. Seeking medical evaluation and diagnosis from a healthcare professional, such as a podiatrist or orthopedist, can help determine the exact cause of the symptoms and provide appropriate treatment recommendations.

Diagnosis and Tests

Diagnosis and tests play a crucial role in identifying posterior tibial tendonitis. By evaluating the symptoms and conducting specific examinations, healthcare professionals can accurately diagnose this condition. Additionally, various imaging tests and other diagnostic methods are utilized to provide a comprehensive assessment.

During a physical examination, the healthcare provider will assess the patient’s medical history and inquire about the symptoms experienced. They will then proceed to examine the affected foot, looking for signs of swelling, tenderness, and deformities. Evaluating the range of motion and strength of the foot and ankle may also be included in the examination.

Imaging tests are commonly employed to confirm the diagnosis. X-rays are useful in ruling out other conditions such as fractures or arthritis. Magnetic resonance imaging (MRI) scans provide detailed images of the soft tissues, including the posterior tibial tendon, helping to identify any tears, inflammation, or degeneration.

It is important to consult with a healthcare professional if you suspect you have posterior tibial tendonitis. They will use a combination of these diagnostic approaches to accurately diagnose the condition, enabling the development of an appropriate treatment plan.

Foot Pain from Posterior Tibial Tendonitis

Management and Treatment

When it comes to managing and treating posterior tibial tendonitis, there are various options available depending on the severity of the condition. Non-surgical treatments are often recommended as the first line of defense, while more severe cases may require surgical interventions.

For individuals with mild to moderate posterior tibial tendonitis, non-surgical treatment options can be effective in relieving pain and promoting healing. These may include:

• Rest and Immobilization: Giving the affected foot and ankle adequate rest and immobilizing it with a brace or cast can help alleviate stress on the tendon and facilitate healing.
• Physical Therapy: A physical therapist can design a customized exercise program to strengthen the muscles around the tendon and improve flexibility. This may involve stretches, range of motion exercises, and specific strengthening exercises.
• Orthotic Devices: Wearing orthotic devices, such as shoe inserts or custom-made orthotics, can provide support to the arch of the foot and reduce strain on the posterior tibial tendon.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to alleviate pain and reduce inflammation in the affected area.

Surgery

In cases where non-surgical treatments fail to provide relief or when the condition is severe, surgical interventions may be necessary. Surgical options for posterior tibial tendonitis include:

• Tendon Repair: If the tendon is torn or severely damaged, surgical repair may be required to restore its function and stability.
• Tendon Transfer: In some cases, a tendon transfer procedure may be performed, where a healthy tendon from another part of the body is used to replace the damaged posterior tibial tendon.
• Joint Fusion: In advanced cases where the joint is severely affected, fusion surgery may be recommended to provide stability and alleviate pain.

It’s important to note that the specific treatment approach will depend on the individual’s condition and should be determined by a qualified healthcare professional. If you suspect you have posterior tibial tendonitis, it’s advisable to consult with a specialist who can provide an accurate diagnosis and recommend the most appropriate management and treatment options.

Prevention

To prevent posterior tibial tendonitis, it is important to take proactive measures and make lifestyle changes that reduce the risk of developing this condition. Here are some tips to help you prevent posterior tibial tendonitis:

1. Wear proper footwear: Choose shoes that provide adequate support and cushioning for your feet. Opt for shoes with arch support and a snug fit to minimize stress on the posterior tibial tendon. Avoid high heels and shoes that lack proper stability.

2. Use orthotics: Orthotic inserts can help correct foot alignment and distribute pressure evenly. These inserts can provide additional support to the arch and reduce strain on the posterior tibial tendon. Consider consulting a podiatrist to get custom orthotics that address your specific needs.

Foot Orthotics

3. Maintain foot and ankle strength: Regular exercises and stretches can help maintain the strength and flexibility of your foot and ankle muscles. Strengthening exercises, such as toe curls and calf raises, can help build strength in the muscles that support the posterior tibial tendon. Additionally, performing ankle stretches and range-of-motion exercises can improve flexibility and reduce the risk of overuse injuries.

By following these preventive measures, you can reduce the likelihood of developing posterior tibial tendonitis. However, if you experience any persistent pain or discomfort in your foot or ankle, it is important to consult an orthopedic surgeon for an accurate diagnosis and appropriate treatment.

Jacksonville Orthopaedic Institute

At JOI Online, our dedicated healthcare providers specialize in diagnosing and treating various foot conditions, including heel pain. Don’t delay in seeking help, contact us today to schedule an appointment and find the relief you deserve.

Related Links: Fixing Ankle Arthritis: Total Ankle Replacement, Hammer Toes, Understanding Heel Pain and this video on Achilles Tendon injuries. 

By: Dr. Turner Vosseller, Orthopaedic Foot and Ankle Surgeon

Dr. Vosseller is an Internationally Recognized Orthopaedic Surgeon who practices at the Jacksonville Orthopaedic Institute San Marco Clinic, and he is currently accepting new patients.  JOI is Northeast Florida’s most respected orthopedic practice. To schedule an appointment, please call 904-JOI-2000 or click below to schedule online.