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What is a Posterior Tibial Tendon Injury?
A posterior tibial tendon injury involves damage or inflammation of the tendon that runs along the inside of the ankle and foot. This tendon connects the calf muscle to bones on the inside of the foot and helps support the arch. Injury or degeneration of this tendon can lead to pain, swelling, and even progressive flattening of the foot (adult-acquired flatfoot deformity).
What are the Causes of Posterior Tibial Tendon Injury?
Posterior tibial tendon injuries often result from overuse, degeneration, or trauma. Common causes include:
- Overuse and repetitive stress – Common in athletes or individuals who spend long hours on their feet.
- Degenerative changes – Tendon wear and tear over time, especially in middle-aged or older adults.
- Acute trauma – A fall, twist, or direct blow to the ankle can cause sudden injury.
- Obesity or poor foot mechanics – Flat feet or excessive pronation can strain the tendon.
- Inflammatory conditions – Diseases such as rheumatoid arthritis can weaken tendons.
What are the Symptoms of Posterior Tibial Tendon Injury?
Symptoms may begin gradually or suddenly depending on the cause. Common signs include:
- Pain and swelling along the inside of the ankle and foot.
- Tenderness behind the inner ankle bone (medial malleolus).
- Flattening of the arch or rolling in of the ankle over time.
- Weakness when trying to stand on tiptoe or push off the foot.
- Difficulty walking or prolonged standing due to pain.
How is Posterior Tibial Tendon Injury Diagnosed?
Diagnosis includes a thorough physical examination, gait assessment, and review of symptoms. Imaging studies such as MRI or ultrasound can evaluate the extent of tendon damage or inflammation. X-rays may be used to assess changes in foot alignment or rule out other conditions.
What are the Treatment Options for Posterior Tibial Tendon Injury?
Treatment depends on the severity of the injury. Mild to moderate cases are managed with rest, ice, anti-inflammatory medications, orthotics, and physical therapy to strengthen the tendon and restore foot alignment. Severe or chronic cases may require bracing or surgical repair or reconstruction to restore proper tendon function and foot structure.
If you wish to be advised on the most appropriate treatment, please call to schedule an appointment or click to request an appointment online.
