Brief Outline of Posterior Tibial Tendinitis
Pain along the medial (inner) side of the lower leg, ankle, and foot may be the result of posterior tibial tendinitis. The posterior tibial tendon helps hold the longitudinal arch of the foot, which means there is a level of tension and friction in the tendon. If the arch falls, the stress on the tendon will increase. This can occur with poor running mechanics, improper footwear, or untreated injuries.
Anatomy and physiology
The posterior tibial tendon runs from the calf muscle behind the medilal malleolus (the bony prominence) of the ankle, to the navicular bone in the arch of the foot. This tendon supports the arch and aids in inversion of the foot. If the navicular moves out of place, it causes stress and irritation to the tendon. This irritation over time becomes tendinitis, inflammation of the tendon.
Cause of Injury
Improper running mechanics. Improper footwear. Prior injury to the medial side of the ankle.
Signs and symptoms
Pain and tenderness over the inner side of the shin, ankle, and foot. Pain when walking or running. Some sweling may be noted over the tendon.
Complications if left unattended
If left unattended, this condition can lead to fallen arch or a complete rupture of the tendon. The pain may cause a change in footfall during running leading to injuries in other structures of the foot and ankle.
- Anti-inflammatory medication
Rehabilitation and prevention
After pain subsides, it is important to stretch and strengthen the calf muscles to support the tendon and speed recovery. Arch supports may be required until the tendon heals and the muscles are strengthened. Gradual reintroduction into activity is important and proper warm-ups will help prevent a recurrence of the injury. Proper footwear and corrections of any mechanical inefficiency will also help prevent this injury.
Proper treatment should lead to a complete recovery. The longer the condition exists before treatment the longer the recovery will take. In some cases, orthotics may be required to prevent a recurrence.