Posterior tibial tendon injury
What is it?
Injury to the posterior tibial tendon (also known as the tibialis posterior tendon), a tendon which is located at the back of the leg and which passes underneath the inside knob of the ankle bone and then inserts onto the small bones in front of the heel. This tendon helps to point the foot down and in. Injury may involve inflammation, overstretching, or even rupture of the tendon.
Symptoms
Pain or tenderness on the inside of the shin, ankle or foot. Flattening of the medial longitudinal arch of the foot may be seen and there may be pain along the medial arch. The ankle may eventually roll inwards as the foot and toes turn outwards. There may be aching and muscle fatigue.
Causes
Overuse of the tendon — which may be caused by walking, running, hiking or stair-climbing. Those affected are often women over 40 years.
Treatment
Initial treatment may include applying ice, elevation of the affected limb and anti-inflammatory medicines. Taping, casts and taking the weight off the foot with crutches are sometimes also used in the initial stages. Orthotics to reposition the affected foot and take the strain off the tendon may be required. Exercises to strengthen the tibialis posterior muscle can be prescribed by a physiotherapist or sports physician. If left untreated, this injury may lead to irreversible damage, such as a flat foot, painful arthritis and mobility problems.
Last Reviewed: 14 August 2009
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