Wednesday, September 15, 2010

Posterior Tibial Tendon Dysfunction

Tendons are what attach our muscles to our bones. Sometimes with an overuse injury you can get something called tendonitis, which means inflammation of a tendon. For the foot and ankle this is most commonly found in the Achilles tendon, and the posterior tibial muscle. We have discussed the Achilles here before so let’s take a look at the other muscle problem, posterior tibial tendon dysfunction.

The posterior tibial tendon starts in the calf, runs down behind the inside of the ankle and attaches to bones in the middle of the foot. This orientation helps hold your arch up and gives you support as you walk. Any injury to this tendon may have you feeling pain on the inner ankle and your arch may progressively fall, leading to flatfoot. Other symptoms could include heel pain, pain upon weight-bearing, especially when walking or running. You may also have instability when standing on your toes and tenderness over your midfoot. So who’s at risk for this? This occurs more often in women over 50 and also can affect those that are obese, diabetic, hypertensive, or a have history of an inflammatory disease.

Your podiatrist can diagnose this through a series of clinical tests and by looking at your foot structure. They may also possibly get an x-ray, ultrasound, or MRI. To treat this painful condition your podiatrist will look at how far along in the condition you are. In the early stages this can be treated by anti-inflammatory drugs, rest, and immobilization. For later stages, custom foot orthoses may be recommended to correct the biomechanical deformity of the foot. And for severe cases, surgery may be needed to treat the dysfunction. Posterior tibial tendon dysfunction can lead to other foot ailments so be sure to see Dr. Grimm or Dr. Pattison before this condition gets worse.