Posterior tibialis tendon dysfunction

Female runner leg stretch
Getty Images under licence to PhysioQinetics Ltd.


What is posterior tibialis tendon dysfunction?

The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in flattening of the foot. It has also been referred to as adult acquired flatfoot because it is the most common type of flatfoot developed during adulthood.

Overuse of the posterior tibial tendon is often the cause and it usually occurs after activities that involve the tendon, such as running, walking, hiking or climbing stairs. The symptoms may include pain on the inside of the foot and ankle, swelling, a flattening of the arch and an inward rolling of the ankle. 


Treadmill running for biomechanical assessment
Getty Images under licence to PhysioQinetics Ltd.


Treatment for posterior tibialis tendon dysfunction

Physiotherapy will involve methods to reduce pain, strengthening of the ankle and foot, as well as proprioceptive exercises to prevent future  recurrence. Manual therapy such as soft tissue techniques and massage can address imbalances such as tightness in the calf muscles, and friction massage can help stimulate the healing process of the tendon itself. Joint mobilisation can also be helpful in realigning and correcting any positional problems. Ultrasound, or other types of electrotherapy to can reduce pain, facilitate healing and stimulate tendon activity. 

It is also important to assess the biomechanics of the lower limb and see whether any problems higher up the kinetic chain are contributing to the foot trouble. For example, weakness around the hip or lack of stability at the pelvis often allow the knee to roll inward and thereby alters stresses and loading down the entire limb through the running cycle. Alternatively, if there are contributing factors from the foot biomechanics, then you may need to see our Podiatrist for custom-made orthotics.


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