Posterior tibial tendinitis, also called posterior tibialis tendinitis or posterior tibial tendon dysfunction, is an inflammatory condition that affects the posterior tibial tendon of the foot. This tendon extends from the leg down to the inside of the ankle and to the arch of the foot. When the tendon is working correctly, it provides support to the foot, and is particularly important for walking. In someone with posterior tibial tendinitis, the tendon becomes overstretched or inflamed, and does not provide the required support. This condition causes pain and swelling of the foot and flattening of the arch, and may lead to arthritis of the foot and ankle.
One of the most common causes of posterior tibial tendon dysfunction is simply overuse of the tendon itself. Overuse during activities such as running, hiking, and dancing is common. Traumatic injury to the lower leg or foot may also cause tendon inflammation. In addition, tendons naturally degenerate with age, increasing the likelihood of tendinitis. Finally, a style of walking in which the ankles roll inward can cause tendinitis, as this gait puts pressure on the inner part of the foot, and on the posterior tendon.
Initial symptoms of posterior tibial tendinitis include pain in the inner ankle and foot, where the tendon is located. The affected part of the foot may also be swollen and red. If left untreated, the arch of the foot will begin to flatten, and the pain may worsen. In addition the ankle will roll further inward and the toes will begin pointing outwards. If the condition advances further, deterioration of the tendon may lead to more widespread pain and further flattening of the arch.
There are several types of posterior tibial tendinitis treatment. An individual with this condition generally has more treatment options if he or she seeks treatment when symptoms first appear. One of the most common treatments is an orthotic device, often in the form of a stirrup, which provides extra support for the foot. If complete immobilization of the foot is required to allow time for healing, a cast may be worn. Pain and inflammation can be treated with anti-inflammatory medication, and physical therapy may be used to improve the strength of the foot.
If the condition is left untreated, or if initial treatments fail to have any effect, posterior tibial tendinitis surgery may be required. Surgery is carried out to repair the tendon if it has degenerated, or to realign foot bones if they have become displaced. Surgery may be followed by use of a cast and physical therapy to help the foot heal.