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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.



This web site is intended for your own informational purposes only. No person or entity associated with this web site purports to be engaging in the practice of medicine through this medium. The information you receive is not intended as a substitute for the advice of a physician or other health care professional. If you have an illness or medical problem, contact your health care provider.


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