Posterior Tibial Tendonitis
Medically Reviewed By : Dr Sravya, MBBS, MS
Introduction
Posterior Tibial Tendonitis or it is also, known as, Posterior Tibial Tendonitis Dysfunction(PTTD), is a kind of painful condition, which does affect the ankle or foot. It might be affecting the ability, for performing a certain amount of lower body movements or walking. Posterior Tibial Tendonitis can also, be treated through surgical or non-surgical methods.
The Posterior Tibial Tendon connects the calf muscle to the bones, which are inside the foot. The main purpose of the tendon is to support the arch, inside the foot. When the tendon breaks down or gets injured, it might not be able to support the arch. It can also, be a painful injury, which negatively affects the ankle and foot movements, including, running and walking.
Posterior Tibial Tendonitis is the most common cause of adult-acquired flatfoot.
Which Is Been Affected By This Condition?
The condition of Posterior Tibial Tendonitis, do mainly affect women and people who are ageing above 40. The tendon often breaks down or degenerates, as a person gets older. As such, it can also, be affecting to people with:
- Having prior surgery.
- Having injuries in ankle or foot tissues.
- Having high blood pressure, Hypertension.
- Having consumed steroids.
- Having joint disorders.
- Having diabetes.
- Having obesity.
The tendon can also be experiencing damage, from overuse or a fall. The people who are participating in the sports activities, such as basketball, baseball, soccer, football, running or track, might be tearing the tendon, from repeated usage.
Signs And Symptoms
The signs and symptoms of the condition Posterior Tibial Tendonitis, can be including:
- Having a previous limp, that, might be worsened.
- Having difficulty while climbing up the stairs and walking.
- Having ankle rolled inwards.
- Having swelling and pain, inside the foot and ankle. This might be increasing the pain, including, walking and running.
- Having uneven or unusually worn shoes.
- Having difficulty while walking on uneven surfaces.
- Having pain, when standing on toes.
Causes
- Repetitive and strong forces, can be injuring the Posterior Tibial Tendonitis. As a person gets older, the tendon breaks down. People who are having additional body weight or obesity can be causing the tendon to break down faster. Prior joint, ankle, or foot injuries, can also, cause the tendon to break down easily.
- In the young blood, the condition of Posinterior Tibial Tendonitis is most commonly seen. It often occurs, after an injur
Diagnosis
The orthopaedic surgeons or physiotherapists, will be seeing the swelling along the Posterior Tibial Tendonitis in the foot and ankle. They will be moving the foot from side to side and checking the ankle’s Range of Motion(ROM). Pain, swelling, weakness or tenderness, when moving the ankle or foot are the early signs and symptoms of Posterior Tibial Tendonitis.
The orthopaedic surgeons or physiotherapists will be examining the foot, from behind to look, if changes are been observed in its shape or structure. The knee might be pointing outward and the inner arch might rest flat on the ground. The front side of the foot might also, move away, from the body to counterbalance the changes to the inner arch and heel.
From behind the foot, orthopaedic surgeons or physiotherapists, will also, be looking at the “Too many toes sign”. In the normal foot, only the fifth toe and parts or all of the fourth toes, are been visible on the foot. In people, who are having the condition of Tibial Tendonitis, more toes are been visible.
A single-limb heel-rise test, can also, help determine the condition of the Posterior Tibial Tendonitis. For this type of test, a person he/she, has to stand on a chair or next to the wall, for supporting the balance. After this, raise the foot off the ground and attempt to lift it onto the toes of the affected foot. Having a healthier tendon, they should be able to complete 8 to 10 heel raises. In the early stages of Posterior Tibial Tendonitis, it might not be possible, for completing the one single heel raise. There are some tests, for diagnosing this condition, are:
1. Computerized Tomography(CT Scan):
Computerized Tomography(CT Scan), do creates a 3D image of the bones and soft tissues. It does provide more detailed images than an X-ray. A Computerized Tomography(CT Scan), might help in confirming the condition of Posterior Tibial Tendonitis or Arthritis.
2. X-ray:
X-rays of the sides of the feet, front and back, will be providing detailed images of the bones. X-rays do help to spot, the fallen arches on Arthritis. They might also, be helpful to spot joint degeneration in the later stages of Posterior Tibial Tendonitis.
3. Ultrasound:
An ultrasound can be helpful for the examination of the size of the tendon, spots the fluid in the tissue, which surrounds the tendon and does observe any tissue degeneration, which might be appeared in the early stages of this condition.
4. Magnetic Resonance Imaging(MRI):
Magnetic Resonance Imaging(MRI), can be determining the health of thetendon and surrounding muscles. In the early stage, Magnetic Resonance Imaging(MRI), might be used to plan surgical treatments, whereas, in the later stage Magnetic Resonance Imaging(MRI), might be used to plan for the surgical treatments.
Treatments
The treatments of Posterior Tibial Tendonitis, do depend upon how the severe signs and symptoms are. If the tendon damage is been identified in its earlier stages, many of the signs and symptoms. will be going away without the non-surgical treatments, are:
1. Physiotherapy:
Physiotherapy exercises do helps to strengthen the muscles. Stretching the lower leg, such as, by standing calf stretches the way stretching calf muscles and tendons, surround it. For example, A foam roller can be loosening the calf muscles. Doing toe standing, walking on the toes, resistance band exercises and single-heel rises would help to prevent injuries by strengthening the ankle and foot muscles.
2. Ice:
For reducing the amount of pain or swelling, orthopaedic surgeons or physiotherapists will be recommending e patient can apply an ice pack covered in a napkin or a towel, on the painful areas of the ankle or foot, four to five times a day, for about 15 to 20 minutes.
3. Rest
The patient should stop participating in activities, which can be worsening or cause pain. For reducing or making muscle movement easier with stretchability, exercises are much more helpful for maintaining overall health without affecting the tendon. It can be including, yoga, swimming, riding a cycle or elliptical training.