Posterior Tibial Tendon Dysfunction | Orthopaedics | Loyola Medicine

Posterior Tibial Tendon Dysfunction

Overview and Facts about Posterior Tibial Tendon Dysfunction

Posterior tibial tendon dysfunction is one of the most common orthopaedic conditions of the foot and ankle. When the tendon becomes inflamed or torn, it may not be able to provide stability and support for the arch of the foot. This causes a collapse in the arch and flat foot.

Signs and Symptoms of Posterior Tibial Tendon Dysfunction

The signs and symptoms of this orthopaedic condition include:

  • Pain and possible swelling along the inside of the foot and ankle, which is where the tendon is located.
  • Pain that becomes more intense with certain activities, such as running.
  • Pain on the outside of the ankle due to the heel bone moving to a new position when the foot collapses. This increases pressure in the area. The pain is similar to arthritis in the back of the foot.
  • For some people, difficulty walking or standing for prolonged periods.

Causes and Risk Factors of Posterior Tibial Tendon Dysfunction

A posterior tibial tendon dysfunction can occur after a fall or due to overuse. People who play high-impact sports, like basketball or soccer, can suffer from tears or inflammation in the tendon from repetitive use. This can lead to the arch collapsing slowly over time. The injury is more likely to occur in women and people older than 40. Other risk factors include:

  • Diabetes
  • Obesity
  • Hypertension

Tests and Diagnosis of Posterior Tibial Tendon Dysfunction

The doctor will perform a foot and ankle examination to check your movement abilities in the area. For example, he or she may ask you to stand on your tip toes, which requires tendon strength, or ask you to move your foot from side to side. They may also observe how your foot looks from the back. If they observe your heel while you are standing and can see two toes jutting from the side, then most likely there is tendon damage.

In order to confirm the diagnosis, imaging tests, such as an X-ray, CT scan, MRI or ultrasound, will provide the doctor with a clearer picture of the structural issues going on inside in the foot.  

Treatment and Care for Posterior Tibial Tendon Dysfunction

Resting, icing, and taking anti-inflammatory medications are normally the first step in a treatment plan for posterior tibial tendon dysfunction. The majority of people with this condition can be treated using just orthotics, braces, and physical therapy if needed to help strengthen the tendon. If these do not provide relief, surgery can be an option. Removing inflamed tissue from the area or repairing a small tear might be all you need; however, a more invasive surgery could be required. People tend to experience some limitations in activity after the surgery.