Tendinopathy is an injury to the tendon. It can cause pain, swelling, and limit movement. The injuries can include:
The posterior tibial tendon runs from the posterior tibial muscle to the inside of the ankle and the arch of the foot. The main job of this tendon is to support the arch of the foot. If the tendon is injured or weak the arch of the foot can collapse. This will make the foot pronate, or roll inward. These injuries can make it painful to walk.
Treatment depends on the severity of the tendinopathy.
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Causes of posterior tibial tendinopathy include:
Posterior tibial tendinopathy is more common in women and in people over the age of 40 years. Other factors that increase your chance of posterior tibial tendinopathy include:
Symptoms may include:
The doctor will ask about your symptoms and medical history. A physical exam will be done. Pain in the foot and ankle can be due to many causes. Posterior tibialis tendinopathy can be difficult to diagnose.
The doctor will try to feel the tendon through your skin. He will note how the foot moves and handles resistance to moving the foot inwards. The doctor will look at the foot from behind and from the side and see how flat the arch is. You may be asked to try to stand on the ball of your foot. If you cannot do this you are likely to have a problem with your posterior tibial tendon.
Your doctor may recommend image tests to see the the structure of the foot and ankle. Tests may include:
Talk to your doctor about the best treatment plan for you. Options include:
To reduce pain and swelling:
To help support the foot and promote healing, you may need:
To help manage pain, your doctor may recommend:
Physical therapy will help:
In rare cases, surgery may be required to repair the tendon.
To reduce your chances of posterior tibialis tendinopathy, take these steps:
American Academy of Orthopaedic Surgeons Ortho Info
The American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Gluck GS ,et al. Tendon disorders of the foot and ankle, part 3: the posterior tibial tendon. Am J Sports Med. 2010;38(10):2133-2144.
Mazieres B, et al. Topical ketoprofen patch in the treatment of tendinitis: a randomized, double blind, placebo controlled study. J Rheumatol. 2005;32(8):1563-1570.
Posterior tibial tendon dysfunction. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00166. Updated December 2011. Accessed May 6, 2013.
Posterior tibialis tendinopathy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 3, 2012. Accessed May 6, 2013.
Tibialis posterior tendinosis and tibialis posterior tenosynovitis. Merck Manual for Health Care Professionals website. Available at: http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/foot_and_ankle_disorders/tibialis_posterior_tendinosis_and_tibialis_posterior_tenosynovitis.html. Updated January 2013. Accessed May 6, 2013.
Last reviewed March 2014 by Teresa Briedwell, PT, DPT, OCS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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