Back

Posterior Tibial Tendonopathy

(Posterior Tibial Tendonitis; Posterior Tibial Tendonosis)

Definition

Tendonopathy is an injury to the tendon. It can cause pain, swelling, and limit movement. The injuries can include:
The posterior tibial tendon runs from the posterior tibial muscle to the inside of the ankle and the arch of the foot. The main job of this tendon is to support the arch of the foot. If the tendon is injured or weak, then the arch of the foot can collapse. This will make the foot pronate, or roll inward. These injuries can make it painful to walk.
Treatment depends on the severity of the tendonopathy.
Tendonitis
Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.

Causes

Causes of posterior tibial tendonopathy include:

Risk Factors

Posterior tibial tendonopathy is more common in women and in people over the age of 40 years. Other factors that increase your chance of posterior tibial tendonopathy include:

Symptoms

Symptoms may include:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. It will include a foot exam. You may be asked to try to stand on the ball of your foot. If you cannot do this you are likely to have a problem with your posterior tibial tendon.
Images of your foot and ankle may be taken. This can be done with:

Treatment

Talk to your doctor about the best treatment plan for you. Options include:

Supportive Care

The foot and ankle will need time to heal. RICE is often the main part of treatment:
  • Rest—Avoid activity that causes pain. Reduce shock or vibrations to the foot and ankle.
  • Ice—Ice therapy may help relieve swelling.
  • Compression—Compression bandages can provide gentle pressure to help move fluids out of the area.
  • Elevation—Keeping the foot elevated can help fluids drain out or prevent fluids from building up.
To help support the foot and promote healing, you may need:
  • A strap or tape for your foot
  • A brace or cast
  • Custom-made orthotics
Prescription or over-the-counter medication may be advised to reduce pain.

Physical Therapy

A physical therapist will assess your foot and ankle. An exercise program will be created to help recovery and to strengthen the muscles.
Surgery
In rare cases, surgery may be required to repair the tendon.

Prevention

To reduce your chances of posterior tibialis tendonopathy, take these steps:

RESOURCES

The American Orthopaedic Society for Sports Medicine http://www.sportsmed.org

OrthoInfo—American Academy of Orthopaedic Surgeons Ortho Info http://www.orthoinfo.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

Gluck GS ,et al. Tendon disorders of the foot and ankle, part 3: the posterior tibial tendon. Am J Sports Med. 2010;38(10):2133-2144.

Mazieres B, et al. Topical ketoprofen patch in the treatment of tendinitis: a randomized, double blind, placebo controlled study. J Rheumatol. 2005;32(8):1563-1570.

Posterior tibial tendon dysfunction. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00166. Updated December 2011. Accessed March 9, 2015.

Posterior tibialis tendinopathy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 29, 2014. Accessed March 9, 2015.

Tibialis posterior tendinosis and tibialis posterior tenosynovitis. Merck Manual for Health Care Professionals website. Available at: http://www.merckmanuals.com/professional/musculoskeletal%5Fand%5Fconnective%5Ftissue%5Fdisorders/foot%5Fand%5Fankle%5Fdisorders/tibialis%5Fposterior%5Ftendinosis%5Fand%5Ftibialis%5Fposterior%5Ftenosynovitis.html. Updated October 2014. Accessed March 9, 2015.

Revision Information