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Posterior Tibial Tendinopathy
(Posterior Tibial Tendonitis; Posterior Tibial Tendinosis)
- Tendonitis—an inflammation of the tendon
- Tendinosis—tiny tears in the tendon with no significant inflammation
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- Overuse of the tendon
- Poor blood supply to the tendon
- Biomechanics that cause degeneration of the tendon, such as over pronation of the foot
- Flat feet
- High blood pressure
- Previous surgery or trauma
- Local steroid injections
- Pain and swelling near the arch of the foot and on the inside of the ankle
- Pain that increases when standing on the ball of the foot or if the foot is flexed
- Pain that increases with activity
- Tiredness in the foot after little activity
- Pain that becomes more disabling
- Later in the course of the tendinopathy, a flattening of the arch of the foot and pronation
- An inability to push off well when running
- Avoid activity that causes pain. Reduce shock or vibrations to the foot and ankle.
- Apply an ice pack for 15-20 minutes at a time, several times a day. Place a towel between the ice pack and your skin.
- Wrap your injured foot in elastic bandaging. Don't wrap the bandage too tight. It may cut off circulation.
- Elevate your foot above your heart.
- A strap or tape for your foot
- A brace or cast
- Custom-made orthotics
- Over-the-counter pain relievers, such as acetaminophen or non-steroidal anti-inflammatory medication (NSAIDs)
- Topical pain medications that are applied to the skin
- Prescription pain relievers
- Stretch and condition the the posterior tibial muscles
- Maintain muscle strength, flexibility, and endurance
- Improve balance and range of motion
- Avoiding activities and sports that repeatedly stress the foot and ankle.
- Maintain proper muscle strength.
- Gradually increasing the frequency and intensity of exercise.
- Wear good, supportive shoes that provide arch support.
- Use proper technique for sports and dance activities.
American Academy of Orthopaedic Surgeons Ortho Info http://www.orthoinfo.org
The American Orthopaedic Society for Sports Medicine http://www.sportsmed.org
Canadian Orthopaedic Association http://www.coa-aco.org
Canadian Orthopaedic Foundation http://www.canorth.org
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 May 6, 2013.
Posterior tibialis tendinopathy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated November 3, 2012. Accessed May 6, 2013.
Pediatric and adolescent sports injuries. Clinics in Sports Medicine . 2000.
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 January 2013. Accessed May 6, 2013.
- Reviewer: John C. Keel, MD
- Review Date: 03/2013
- Update Date: 03/01/2013