Overview

Tibialis Posterior Tendinopathy is a very common foot and ankle problem, experienced when the tibialis posterior tendon becomes irritated or damaged. The main function of this tendon is to hold up the arch and support the foot during walking. If this tendon is damaged, the arch will slowly collapse over a period of time.

This condition is more likely to occur in women, people over the age of 40 and those who are obese and have diabetes or hypertension.

Causes

The most common causes of Tibialis Posterior Tendinopathy are:

  • Continued wearing of poorly fitting or unsupportive shoes.
  • Trauma or injury to the ankle joint.
  • Poor foot posture, with too much pressure placed on the ankle joint.
  • Overuse of the tendon by athletes or physically active people.
  • overweight

Symptoms

  •  Pain experienced on the inside of the foot and ankle.
  • People feeling unsteady on their feet, experiencing weak muscles or difficulty rising onto their toes on the side that is affected.
  • Pain which gets worse with movement or long periods of standing.
  • Pain experienced on the outside of the ankle. This occurs as a result of the heel bone repositioning itself and placing pressure on the outside ankle bone.
  • More serious cases can result in a flattening of the inside arch of the foot resulting in Flat Foot, and toes ‘splaying’ outwards.

Diagnosis

A podiatrist can diagnose a case of Tibialis Posterior Tendinopathy through a physical exam of the foot and ankle area and an investigation of your symptoms. Your podiatrist may assess your range of motion and flexibility by observing your walk. Your podiatrist may also recommend an X-ray, MRI, CT Scan or ultrasound.

Treatment

Dan Everson Podiatry recommends a treatment option based on the nature and severity of your injury. These may include:

  • Rest and modifying your lifestyle to reduce or stop painful activities. Changing to low impact exercise is usually recommended.
  • Heat and ice therapy to the affected area three or four times a day to reduce swelling.
  • Strength and conditioning work.
  • Stabilisation (strapping, splitting, casting) may be recommended to allow the area to rest and recover.
  • Surgery may be required in some cases. This may be a simple procedure to remove the inflamed tissue or repair a basic tear or can be complex with longer recovery times.
  • Anti-inflammatory medication.
  • Kinetic Orthotics may be prescribed to help treat this condition and prevent it from recurring.

Prevention

Dan Everson Podiatry recommends the following activities to help prevent Posterior Tibial Tendonitis:

  • Wearing supportive shoes and customised orthotics to reduce stress on the tendon.
  • Performing stretches that strengthen the calf and posterior tibial tendon daily.
  • Balance work on a balance board or Bosu ball can alleviate stress to the tendon.

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