Posterior tibial tendinitis is an inflammation or overstretching of the tendon that connects the calf muscle to the bones on the inside of the foot. This tendon is the primary stabilizer of the foot and is responsible for supporting the arch.
Pain and tenderness along the inside of the ankle and foot.
Swelling that follows the path of the tendon behind the inner ankle bone.
Pain that worsens with activity, especially walking, running, or standing for long periods.
Flattening of the foot arch over time as the tendon weakens.
Inability or difficulty performing a single-leg heel raise, which is standing on one foot and rising onto the toes.
Redness or warmth over the inner ankle area during acute flare-ups.
Physical Examination
X-rays: Used to evaluate the degree of flatfoot deformity or to check for arthritis in the foot joints.
MRI or Ultrasound: These imaging tools provide a detailed look at the soft tissue to identify tears or significant degeneration.
Early intervention is critical to prevent the arch from collapsing permanently.
Rest and immobilization in a walking boot or cast is occasionally used to take all tension off the tendon.
Custom orthotics or arch supports to manually lift the arch and reduce the workload on the tendon.
Physical therapy focusing on eccentric strengthening of the posterior tibialis.
Stretching the calf muscles to reduce the opposing pull on the foot.
Non-steroidal anti-inflammatory drugs to decrease pain and localized swelling.
Icing the inner ankle for 20 minutes several times a day after activity.
Bracing, such as an Arizona brace, for more advanced cases where the arch has already begun to drop.
Surgery to repair the tendon or perform a bone graft if conservative measures fail after six months.