Posterior Tibial Tendonitis Anatomy
- Originates at top back of tibia (shin bone) and inside border of fibula.
- The muscle goes through the back compartment of the leg and its tendon passes behind the medial malleolus (inside ankle bone).
- Inserts onto the navicular tuberosity, the plantar (underneath) portion onto the second, third, fourth metatarsals, second and third cuneiforms, and cuboid.
What Does the Posterior Tibial Tendon Do?
- Primary dynamic stabilizer of the arch of the foot
- Main inverter (turning foot inwards) of midfoot
- Supports the foot while walking
How Does Posterior Tibial Tendonitis Happen?
- Women are more at risk.
- People over the age of 40
- Acute fall or trauma
- Overuse with a flat pronationed (flat) foot – worse with higher impact activities like sports
- Once the tendon is inflamed or torn, the arch will slowly fall over time if not addressed.
Posterior Tibial Tendonitis Symptoms
- Pain along inside leg down into ankle
- Swelling along inside of ankle – not always
- Pain with weight bearing activities such as standing or walking that gets progressively worse
- In more severe cases a person can have pain on outside part of ankle because when the arch collapses bones can shift.
- Difficulty balancing or unsteady gait
- A flat foot with toes pointing outwards
- Pain with eversion (turning foot out) and pain with plantarflexion (pointing foot down like pushing on a gas pedal)
Posterior Tibial Tendon Dysfunction is divided into stages by most foot and ankle specialists:
- There is pain along the posterior tibial tendon without deformity or collapse of the arch. The patient has the somewhat flat or normal-appearing foot they have always had.
- Deformity from the condition has started to occur, resulting in some collapse of the arch, which may or may not be noticeable.
- The patient may feel it as a weakness in the arch.
- Many patients initially present in stage II, as the ligament failure can occur at the same time as the tendon failure and therefore, the deformity can already be occurring as the tendon is becoming painful.
- The deformity has progressed to the extent where the foot becomes fixed (rigid) in its deformed position
- Deformity occurs at the ankle in addition to the deformity in the foot
For more information about this condition, click on the article below: