Posterior tibial tendonitis
Posterior tibial tendonitis is inflammation of the tendon that runs behind the inner ankle bone and supports the arch of your foot. It causes pain and swelling on the inside of the ankle, often with walking or sport. Fiona assesses it in an initial consultation from $100, and strapping, orthotics and stretching programs can help.
What posterior tibial tendonitis is
Posterior tibial tendonitis is inflammation of the posterior tibial tendon, one of the most frequently affected tendons in the foot. The tendon runs behind the inside bump on the ankle, across the instep, and attaches to the bottom of the foot. It works hard during the contact phase of gait, when the foot is on the ground. Thick fibrous tissues hold it in place and form a lever behind the ankle bone, which slows the foot down when the heel strikes the ground.
Symptoms
Symptoms of posterior tibial tendon dysfunction include:
- Pain in the instep area of the foot
- Swelling along the course of the tendon
- Pain and swelling right behind the inner ankle bone
- Tenderness when the area is touched
- Burning, shooting, tingling or stabbing sensations, because the main nerve along the inside of the ankle may be inflamed
- Pain when exercising or just walking, steadily worsening toward the end of the day
In severe cases, pain can be felt when you slightly move the foot, during passive stretching of the tendon, or on flattening of the foot. The tendon may weaken and tear or rupture in some situations.
Causes and risk factors
Heavy use of the feet, such as playing sport, commonly causes tendonitis in this tendon. The posterior tibial tendon is normally under load throughout the contact phase of gait. Repeated strain from running, jumping or long hours on your feet can inflame it. Flattening of the foot places extra demand on the tendon and can contribute to dysfunction. Weakness and inflammation may progress until the tendon tears or ruptures in severe cases.
Treatment at the clinic
Fiona assesses and diagnoses posterior tibial tendon dysfunction at the clinic, starting with an initial consultation from $100 and standard consultations from $90. She may use strapping and taping to support the ankle, and can advise on ice and compression techniques. Custom orthotics from $650 or semi-custom orthotics from $450 may be advised, and each includes a biomechanical assessment. Fiona can also give you an ankle stretching and strengthening program. Low level light therapy for tendinopathy is part of a standard consultation from $90. Referral for ultrasound or MRI is available when needed.
Looking after it at home
Rest from all activities that cause pain or limping. Ice and compression can be applied to the inner ankle, and Fiona advises you on the technique. Elevate the ankle above heart level when possible. Splinting, taping or bracing may protect the ankle from further injury. Everyone recovers from injury at a different rate, and returning to your sport depends on how the tendon recovers rather than how many days have passed. Returning too soon may worsen the injury and could lead to permanent damage.
When to see a podiatrist
You should see a podiatrist when inner ankle pain or swelling persists, worsens toward the end of the day, or stops you walking or exercising comfortably. Pain on slight movement of the foot, on passive stretching of the tendon, or on flattening of the foot suggests a more severe problem that needs assessment. A suspected tear or rupture of the tendon needs prompt medical attention, and you should see a GP or hospital for that. Fiona assesses posterior tibial tendonitis at Narre Warren, with no referral needed to see a podiatrist privately.
Questions
Is posterior tibial tendonitis the same as posterior tibial tendon dysfunction?
The two terms describe the same tendon problem. Posterior tibial tendonitis refers to inflammation of the tendon, while dysfunction describes the tendon failing to support the arch properly. Symptoms often overlap, including inner ankle pain and swelling.
How do you treat inner ankle pain from the posterior tibial tendon?
Treatment can include strapping and taping, rest from painful activities, ice, compression, elevation, orthotics and an ankle stretching and strengthening program. Fiona can assess your foot in an initial consultation and advise what suits your case. She can refer you for ultrasound or MRI when the diagnosis is unclear.
Can a torn posterior tibial tendon heal on its own?
A torn posterior tibial tendon needs professional assessment. A suspected rupture or tear requires prompt medical attention, so see a GP or hospital. A podiatrist can then help with ongoing care, support and rehabilitation.