The posterior tibialis tendon (PTT) is a strong cord that connects the tibialis posterior muscle in your calf to several bones on the inside of your foot. This muscle is located deep in the back part of your lower leg. The main job of the posterior tibialis tendon is to hold up the arch of your foot. It helps you stand on your toes and turn your foot inward.
Posterior tibial tendonitis happens when the tendon gets swollen and painful, usually because of overuse or an injury. The foot and ankle specialists at Summit Orthopedics in the Minneapolis/St. Paul area accurately diagnose and treat posterior tibial tendonitis with the goal of relieving your symptoms and preventing future problems.
Symptoms of Posterior Tibial Tendonitis
A common symptom is pain and swelling along the inside of the foot and ankle. Symptoms are usually mild in the beginning. At first, you might notice pain only during or after activity. As the condition gets worse, you may notice:
- Difficulty standing and walking
- Pain when standing on your toes
- Severe pain and swelling
- Swelling along the inner ankle
These symptoms can be similar to a condition called posterior tibial tendon dysfunction. Also known as adult-acquired flatfoot or progressive collapsing foot deformity, this condition happens when an injury, arthritis, overuse or even genetics cause your foot’s arch to flatten.
Causes of Posterior Tibial Tendonitis
Posterior tibial tendonitis is often caused by activities, like basketball, tennis and soccer, that put a lot of strain and repeated stress on the foot. You don’t have to be an athlete to get posterior tibial tendonitis. It can happen over time, especially if you wear shoes that don’t support your feet well.
Other causes include:
- Abnormal walking gait
- A sudden injury, such as a fall, that can tear the tendon and lead to chronic inflammation
- Repetitive stress injuries
Diagnosing Posterior Tibial Tendonitis
Your doctor will start by taking a medical history and performing a physical exam. They will check for pain and swelling and look at your foot while you stand.
Imaging tests can also help confirm your diagnosis.
- X-rays. These pictures help the doctor see if the bones have shifted or if there is arthritis.
- MRI. This is the best way to look at soft tissues and surrounding ligaments to check for inflammation or tears.
Nonsurgical Approaches
Most people find relief with nonsurgical treatments, especially if a doctor diagnoses and treats the condition in its early stages. The goal of treatment is to rest the tendon and reduce inflammation.
Nonsurgical treatment options include:
- Activity changes. The first step is to decrease or stop activities that cause pain. You may have to switch the types of activities you do, for example, replacing basketball with swimming.
- Immobilization. In some cases, a special cast or boot may be used to give the tendon a complete rest.
- Medication. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can reduce pain and inflammation and may be part of your treatment plan. NSAIDs work by stopping your body from making certain chemicals that cause inflammation.
- Supportive devices. Orthotics are custom shoe inserts that change the position of your foot and ankle when you walk. They work by helping your foot and ankle bones absorb the impact of walking.
Surgery is for severe cases, and it’s often the most reliable way to help people return to their high-impact activities.
Care for Posterior Tibial Tendonitis at Summit Orthopedics
At Summit Orthopedics, a team of experts works to treat your posterior tibial tendonitis. We combine treatment from several approaches, including physical therapy, medication and surgery if needed.
Summit Orthopedics surgeons are available at nearly 30 convenient locations across the Minneapolis/St. Paul metro area, serving Minnesota and western Wisconsin. Our state-of-the-art, comprehensive orthopedic centers offer same-day appointments from a team of experts who offer the full scope of orthopedic care.
Find your Summit Orthopedics foot and ankle expert,request an appointment or call us at (651) 968-5201 to schedule a consultation.
