Post-Tib Tendonitis
Definition
Post-Tib Tendonitis is a strain placed on the posterior tibial tendon. The posterior tibial tendon runs along the inside of the ankle and the foot. When there is post-tibial tendon disfunction, the tendon does not function to hold up the arch, resulting in flat feet. This can lead to heel pain, arch pain, plantar fasciitis and/or heel spurs. With post-tib tendonitis, pain will be more severe upon weight bearing, especially while walking or running.
Causes
Post-Tib Tendonitis occurs when the muscle is overused and the tendon (soft tissue) that connects the muscle to your bone is strained. Years of over-pronation (flat feet) can also lead to posterior tibial tendon dysfunction. If you keep overusing the muscle, damage to the tendon builds up and tendonitis develops. At first the pain or swelling may come and go quickly, but eventually the problem may become more permanent.
The tendinopathy is caused by overuse of the posterior tibialis tendon. This most often occurs due to:
• Running and jumping
• Dancing, for example ballet pointe work and excessive foot rotation
• Trauma with high impact
Treatment and Prevention
To treat post-tib tendonitis, you can reduce your symptoms by limiting activity to control the pain and swelling. Stay off your feet a few days, then slowly increase your activity. Rest allows the tissues in your foot to heal. Conservative treatments (non-surgical treatments) include wearing a foot orthotic with rearfoot posting and longitudinal arch support to reduce strain on the post tibial tendon and prevent excessive stretching of the plantar fascia. The orthotic should also be designed with materials to comfort the foot and absorb shock. Listed below are tips to prevent Post-Tib Tendonitis from recurring: Wear shoes that provide cushioning, support and shock absorption. Use orthotics with sufficient arch support that are constructed from shock absorbing, cushioning materials. Vary exercise routines. The variety will keep one set of muscles from being under continuous stress.
To help prevent posterior tibial tendinitis, forego high-impact exercise; instead, do low-impact exercise such as bicycling, elliptical trainer or swimming. To help ensure that your feet are optimally protected during activity, IPFH suggests that you wear only properly selected and fitted, as part of an integrated approach, padded socks with shoes with non-slip outsoles and any inserts or orthotics prescribed or recommended by a doctor or foot health professional. Peer-reviewed, published studies have shown that wearing clinically tested padded socks can help prevent injuries to the skin/soft tissue of the foot,due to impact, pressure and shear forces.
Treatment includes rest, cutting back on activities that worsen the pain, icing and anti-inflammatory medication, if tolerated.
For more serious cases, your doctor may prescribe a cast or walking boot, which allows the tendon to rest and the swelling to diminish. Orthotics and braces are often recommended if the condition becomes chronic, and especially if it leads to posterior tibial tendon dysfunction.
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