Posterior Tibial Tendon Dysfunction(Flat Foot)
The posterior tibial tendon is a tendon on the inside of the ankle that provides
stability and support for the arch of the foot. Pain can occur when the posterior
tibial tendon becomes inflamed or torn. This may result in a flatfoot.
Causes & Symptoms
Posterior tibial tendon dysfunction occurs in those with obesity, diabetes,
and hypertension. It is most commonly seen in women and in people older than 40 years
of age. In the setting of an acute injury or chronic over use, the tendon can become inflamed.
Symptoms of posterior tibial tendon dysfunction include pain and swelling along the inside of the foot and ankle and pain that is worse with activity.
Evaluation & Treatment
Initial evaluation includes a detailed history, examination maneuvers, and X-rays.
An MRI or ultrasound may be ordered to evaluate for a tendon tear or extent of tendonitis.
Treatment begins with rest, ice, anti-inflammatory medications, immobilization, orthotics, braces,
and physical therapy. Pain resolves slowly even with treatment and may last 3-6 months with treatment
and sometimes longer if symptoms have been for many months prior to treatment.
Surgery should be considered if pain does not improve despite 6 months of appropriate treatment.
Surgical treatment may be done as an outpatient or overnight procedure. Reduction in pain may take 12 months or longer.