Known as one of the supporting structures of the foot, the posterior tibial tendon helps the foot to function while walking. One of the most common problems related to the foot and ankle, posterior tibial tendon dysfunction is the result of the tendon becoming inflamed or torn.
What are the causes and symptoms of posterior tibial tendon dysfunction?
Posterior tibial tendon dysfunction is caused by changes in the tendon which impair its ability to support the arch of the foot. This causes the flattening of the foot, often referred to as adult acquired flat foot. While it is more common for the condition to develop in one foot, is can also develop in both feet. This condition is often related to overuse of the tendon. Symptoms usually become noticeable after activities involving use of the tendon such as running or walking. Patients may first notice pain on the inside of the foot and ankle and the area may become red, swollen or warm to the touch. As the condition develops, patients may then notice the foot beginning to flatten and the toes turning outward while the ankle rolls inward. Pain can spread to the area below the ankle due to the flattening arch, and the patient may also start developing arthritis in the ankle. Risk factors for developing posterior tibial tendon dysfunction include age, obesity, diabetes, and hypertension.
What is the diagnosis and treatment like for posterior tibial tendon dysfunction?
If not properly treated posterior tibial tendon dysfunction can worsen over time. In order to diagnose this condition a physician will examine the ankle and foot as well as look at the patient’s medical history. The physician will note any limited flexibility the patient may have and assess them performing exercises such as single limb heel raises. Imaging tests such as x-rays may also be ordered to assess the potential need for surgery or to detect arthritis. Ultrasounds, MRIs, and CT scans may also be obtained to establish the diagnosis and guide treatment. Nonsurgical treatments for posterior tibial tendon dysfunction include physical therapy, rest, icing the area, and anti-inflammatory medications. Orthotics and braces can also be recommended for those with severe changes in the shape of the foot or for those who need to take tension off of the tendon. Surgical treatment may be recommend if conservative options are not effective.