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Posterior Tibial Tendon Dysfunction

Arizona Orthopedic Surgery Solutions for Posterior Tibial Tendon Dysfunction

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What is Posterior Tibial Tendon Dysfunction

Posterior tibial tendon dysfunction is one of the most common problems of the foot and ankle. It occurs when the posterior tibial tendon becomes inflamed or torn. As a result, the tendon may not be able to provide stability and support for the arch of the foot, resulting in flatfoot.

Most patients can be treated without surgery, using orthotics and braces. If orthotics and braces do not provide relief, surgery can be an effective way to help with the pain. Surgery might be as simple as removing the inflamed tissue or repairing a simple tear. However, more often than not, surgery is very involved, and many patients will notice some limitations inactivity after surgery.

An acute injury, such as a fall, can tear the posterior tibial tendon or cause it to become inflamed. The tendon can also tear due to overuse. For example, people who do high-impact sports, such as basketball, tennis, or soccer, may have tears of the tendon from repetitive use. Once the tendon becomes inflamed or torn, the arch will slowly fall (collapse) over time.

Posterior tibial tendon dysfunction is more common in women and people older than 40 years of age. Additional risk factors include obesity, diabetes, and hypertension.

Posterior Tibial Tendon Dysfunction Diagnosis

Common symptoms of tibialis posterior tendonitis are pain within the foot and ankle (specifically where the tendon is), difficulty standing or walking for extended periods of time, and increased pain with activity and inability for high-intensity or high-impact activity, and pain on the outer ankle. A damaged posterior tibial will cause the foot to collapse, causing the heel bone to change place, usually outwards. This improper heel position causes pressure on the outside ankle bone, leading to similar pain caused by arthritis in the back of the foot. After a doctor asks about your medical history, they will analyze your foot and ankle. The doctor will check for inflammation by the posterior tibial tendon, starting at the lower leg and extending to the inside of the foot and ankle. Likewise, the doctor will see if the affected foot has changed shape, as the heel will most likely be positioned towards the outside with a fallen arch. If “too many toes” are visible when looking at the foot from behind the heel, this is another tell-tale sign of tibialis posterior tendonitis. Limited range of motion in the ankle and foot and the inability to perform a calf raise indicate that the posterior tibial tendon has been damaged. X-rays, MRIs, CT Scans, and ultrasounds can help a doctor determine the issue. If caught early on, it is normal for pain to linger for more than three months. If dealt with after a few months of pain, pain may take longer than six months of treatment.

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Posterior Tibial Tendon Dysfunction Treatment

It is recommended to cease the physical activity that exerts the tendon. Biking, elliptical machines, and swimming are low-impact activities that allow individuals to continue working out while healing. Apply ice in twenty-minute intervals three to four times each day. Never allow ice to sit directly on the skin. You can take nonsteroidal anti-inflammatories to relieve any pain, but You should schedule a consultation with your primary doctor if still taking over-the-counter medication after a month. Orthotics are recommended to help support the flattened arch, while a lace-up ankle brace is a good idea when reintroducing physical activity. As a brace, boot, or cast causes other muscles to weaken, doctors will usually try to avoid such immobilization devices if possible. Physical therapy is highly recommended to rebuild the damaged tendon. In severe cases, your doctor may use a Cortisone injection as a last resort due to the threat of rupturing the tendon.