Do you have pain along the inside of your foot and ankle? Does the pain get worse with high-intensity or high-impact activities like running, tennis or basketball? Do you have trouble walking or standing for a long time? You may have posterior tibial tendonitis.
The posterior tibial tendon connects the posterior tibial muscle (a muscle attached to the back of your shin bone) to the bones in your foot. This tendon runs down the back of your leg, under the medial malleolus (the prominence at the inner side of the ankle), and attaches to the bone in the inner side of your foot next to the arch. The function of the posterior tibial tendon is to hold up the arch while supporting and controlling the inward movement of your foot while walking.
Posterior tibial tendonitis occurs when the tendon becomes inflamed or tears due to an acute injury or from overuse. Once the tendon is injured, over time, your arch can slowly collapse, resulting in a flat foot.
Symptoms of posterior tibial tendonitis, in addition to those mentioned above, include:
- Pain or tenderness along the tendon and the instep of your foot.
- Possible swelling in the area.
- Pain on the outside of the ankle once the foot collapses.
- Unsteady gait.
If you think you’re suffering from symptoms of posterior tibial tendonitis, schedule an appointment with your doctor for a proper diagnosis.
Most patients can be treated with nonsurgical treatment, including:
- Rest to allow the tendon to heal.
- Ice to reduce pain and swelling.
- Nonsteroidal anti-inflammatory medications to reduce pain and inflammation.
- Immobilization of the ankle with a walking boot or cast for 6 to 8 weeks.
- An ankle brace to take tension off of the tendon and to support the joints in the back of the foot.
- Custom orthotics, like ezWalker® Performance Custom Orthotics, to control the position of your foot and support the posterior tibial tendon during activity. The ezWalker® Custom Orthotic is designed to support the STT joint, which is the joint the posterior tibial tendon wraps around as it attaches to the bone.
- Physical therapy to strengthen the tendon.
You may experience pain from 3 to 6 months after treatment begins. If your pain doesn’t improve after 6 months you may require surgery. The type of surgery varies depending on the severity of your tendonitis, but it may involve lengthening your calf muscles, repairing a tear, removing inflamed tissue, or removing the affected tendon and replacing it with another tendon.
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Note: If you follow these guidelines and your pain persists, you may have a more serious condition. See your doctor for a more complete diagnosis and treatment.