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Posterior Tibial Tendon Dysfunction

The posterior tibial tendon starts in the calf, stretches down behind the inside of the ankle and attaches to bones in the middle of the foot. This tendon helps hold your arch up and provides support as you step off on your toes when walking. If it becomes inflamed, over-stretched or torn, you may experience pain on the inner ankle and gradually lose the inner arch on the bottom of your foot, leading to flatfoot.

Signs and symptoms of posterior tibial tendon dysfunction include:
  • Gradually developing pain on the outer side of the ankle or foot.

  • Loss of the arch and the development of a flatfoot.

  • Pain and swelling on the inside of the ankle.

  • Tenderness over the midfoot, especially when under stress during activity.

  • Weakness and an inability to stand on the toes.

Diabetics, overweight, and hypertensive people are particularly at risk.

Left untreated, posterior tibial tendon dysfunction could lead to arthritis in the hindfoot. Pain could increases and spread to the outer side of the ankle.

Treatment includes rest, over-the-counter nonsteroidal anti-inflammatory drugs, and immobilization of the foot for 6 to 8 weeks with a rigid below-knee cast or boot to prevent overuse. Consult your physician before taking any medications.

When the posterior tibial tendon is inflamed or torn to the point where conservative non-surgical treatments are not alleviating the pain, tendon surgery may be indicated. This type of surgery addresses the tendon itself. The inflammation and degeneration occurring within the tendon is removed and the tendon is repaired if a tear is present. This allows the tendon to function more appropriately.

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