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Posterior Tibial Tendon Dysfunction

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, people with flat feet and overweight people are particularly at risk.

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

Treatment includes rest, over-the-counter Nonsteroidal anti-inflammatory drugs, and immobilization. Physical therapy is also often utilized. This is usually followed by Orthotics to hold up the arch and relieve the tendon. If the tendon is torn or ruptured then surgery is indicated. There are a variety of ways to surgically treat this:
1) Repair the torn tendon by directly suturing it.
2) Perform a tendon transfer or advancement. This requires 6 weeks of non-weight bearing and significant rehabilitation.
3) Subtalar implant to correct flat foot in early stages with quick recovery.
4) Fusion of some of the joints in the hind foot area. This requires 8 weeks of nonweightbearing and long rehabilitation.

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