Posterior Tibialis Tendonitis
Posterior Tibialis
Tendonitis is a strain placed on the
posterior Tibialis tendon. The posterior Tibialis tendon runs along the inside of
the ankle and the foot. When there is post-Tibialis tendon disjunction, the tendon
does not function to hold up the arch, resulting in flat feet. This can lead to heel
pain, arch pain, plantar fasciitis and/or heel spurs. With post-tibial Tendonitis,
pain will be more severe upon weight bearing, especially while walking or running.
Causes of Posterior Tibialis Tendonitis
Injury is the main cause.
- Most injury is caused from strain on the Posterior Tibialis Tendon from over exercision
from sport activity.
- Injury form impact or fall.
- Walking incorrectly on the inside of the foot.
- Diseases such as arthritis.
Symptoms of Posterior Tibialis Tendonitis
- Pain and swelling on the inside of the ankle
- Loss of the arch and the development of a flatfoot
- Gradually developing pin on the outer side of the ankle or foot
- Weakness and an inability to stand on the toes
- Tenderness over the midfoot, especially when under stress during activity
Diagnosis of Posterior Tibialis Tendonitis
The doctor will ask about your symptoms
and medical history, and perform a physical exam, paying special attention to the foot.
Posterior tibialis is Tendonitis 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 Tibialis tendon.
Treatment of Posterior Tibialis Tendonitis
Without treatment, the flatfoot that develops from posterior Tibialis tendon
dysfunction eventually becomes rigid. Arthritis develops in the hindfoot. Pain increases
and spreads to the outer side of the ankle. The way you walk may be affected and wearing
shoes may be difficult.
The treatment your doctor recommends will depend on how far the condition has
progressed. In the early stages, posterior Tibialis tendon dysfunction can be treated with
rest, nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen, and
immobilization of the foot for 6 to 8 weeks with a rigid below-knee cast or boot to
prevent overuse. After the cast is removed, shoe inserts such as a heel wedge or arch
support may be helpful. If the condition is advanced, your doctor may recommend that you
use a custom-made ankle-foot orthosis or support.
If conservative treatments don’t work, your doctor may recommend surgery. Several
procedures can be used to treat posterior Tibialis tendon dysfunction; often more than one
procedure is performed at the same time. Your doctor will recommend a specific course of
treatment based on your individual case. Surgical options include:
- Tenosynovectomy. In this procedure, the surgeon will clean away (debride) and remove
(excise) any inflamed tissue surrounding the tendon.
- Osteotomy: This procedure changes the alignment of the heel bone (calcaneus). The
surgeon may sometimes have to remove a portion of the bone.
- Tendon transfer: This procedure uses some fibers from another tendon (the flexor
digitorum longus, which helps bend the toes) to repair the damaged posterior Tibialis
tendon.
- Lateral column lengthening: In this procedure, the surgeon removes a small wedge-shaped
piece of bone from the hip and places it into the outside of the calcaneus. This helps
realign the bones and recreates the arch.
- Arthrodesis: This procedure welds (fuses) one or more bones together, eliminating
movement in the joint. This stabilizes the hindfoot and prevents the condition from
progressing further.
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