Posterior Tibial Tendonitis

Posterior tibial tendonitis, also known as posterior tibial tendon dysfunction (PTTD) or adult acquired flatfoot, is a condition that involves inflammation and dysfunction of the posterior tibial tendon. This tendon runs along the inner side of the ankle and foot and plays a crucial role in supporting the arch of the foot. When this tendon becomes inflamed or weakened, it can lead to changes in the foot’s alignment and arch structure.

Causes:

• Overuse or Repetitive Strain: Activities that place excessive stress on the posterior tibial tendon, such as running or walking on uneven surfaces, can lead to inflammation and injury.
• Biomechanical Factors: Abnormal foot mechanics, including flat feet or pronation (inward rolling of the foot), can increase the risk of developing posterior tibial tendonitis.
• Age and Degeneration: As we age, the tendons in our bodies can weaken and degenerate, making them more susceptible to injury.

Symptoms:

• Pain: Pain is typically felt along the inner side of the ankle and arch of the foot. The pain may worsen with activity and improve with rest.
• Swelling: Swelling may occur around the affected tendon.
• Flattening of the Arch: Over time, as the posterior tibial tendon becomes dysfunctional, it can lead to a flattening of the arch of the foot, causing a condition known as adult acquired flatfoot.

Diagnosis:

• A healthcare professional, often a podiatrist or orthopedic specialist, can diagnose posterior tibial tendonitis through a physical examination, assessment of symptoms, and sometimes imaging studies such as X-rays or MRI.

Treatment:

• Rest and Immobilization: Resting the affected foot and using a brace, walking boot, or cast may be recommended to allow the tendon to heal.
• Orthotic Inserts: Custom or over-the-counter arch supports can help provide better support and alignment to the foot.
• Physical Therapy: A physical therapist can guide you through exercises to strengthen the muscles that support the arch and improve foot mechanics.
• Medications: Over-the-counter pain relievers or anti-inflammatory drugs may help manage pain and inflammation.
• Corticosteroid Injections: In some cases, a doctor may administer corticosteroid injections to reduce inflammation and pain.
• Footwear Modifications: Wearing supportive shoes with proper arch support and cushioning can help alleviate strain on the tendon.
• Surgery: In severe cases where conservative treatments do not provide relief, surgery may be considered to repair or reconstruct the posterior tibial tendon and restore foot alignment.

Early intervention and appropriate treatment are important to prevent the progression of posterior tibial tendonitis and the associated changes in foot structure. If you suspect you have this condition or are experiencing symptoms, it’s advisable to consult a medical professional for proper evaluation and guidance.