One of the common issues affecting the foot and ankle arises when the posterior tibial tendon malfunctions. This occurs due to sprains or tears in the tendon, leading to inadequate support for the foot arch and potentially resulting in flatfoot.
For many individuals, orthotics and braces can effectively manage the condition without resorting to surgery. However, if these measures prove ineffective, surgery may be considered as a viable option for pain management. Surgical interventions range from simple procedures like removing inflamed tissue to more complex repairs of torn tendons. Nevertheless, surgery can be intricate, often imposing limitations on postoperative activities.
Anatomy
The posterior tibial tendon is a critical structure in the leg, linking the calf muscle to the foot's inner bones. Its primary function is to provide support to the foot arch and uphold its integrity during walking.
Causes
Acute injuries, such as falls, can lead to inflammation or tearing of the posterior tibial tendon. Additionally, overuse can contribute to tendon tears, particularly in individuals engaged in high-impact sports like basketball or tennis. When the tendon is damaged, the foot arch may collapse over time.
Women and individuals over 40 years old are at a higher risk of experiencing posterior tibial tendon dysfunction. Other risk factors include diabetes, hypertension, and obesity.
Symptoms
Symptoms of posterior tibial tendon dysfunction include:
- Pain along the inner side of the foot and ankle, sometimes accompanied by swelling.
- Exacerbation of pain during physical activity, especially high-impact exercises like running.
- Ankle pain on the outer side due to the shifting of the heel bone outward as a result of arch collapse.
- Non-Surgical Therapy
Most patients can find relief from symptoms through nonsurgical approaches. Resting and avoiding aggravating activities is the initial step. Low-impact exercises such as cycling or swimming are recommended to maintain fitness without stressing the foot.
Ice packs can help alleviate pain and swelling when applied to the affected area. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can also reduce inflammation and pain.
Immobilization using a short leg cast or walking boot may be necessary to allow the tendon to rest and heal. Physical therapy focusing on tendon strengthening exercises may benefit individuals with mild to moderate dysfunction.
Medical footwear like DrLuigi shoes can aid in preventing and alleviating symptoms of posterior tibial tendon dysfunction.
In some cases, corticosteroid injections may be considered to reduce inflammation, although this carries a risk of tendon rupture and should be discussed thoroughly with a physician before proceeding.
