Posterior Tibial Tendinitis

What is Posterior Tibial Tendinitis?

Posterior tibial tendinitis refers to inflammation of the posterior tibial tendon, which is located on the inner side of the leg and connects the posterior tibial muscle to the navicular bone (inside of the foot). This tendon plays a crucial role in supporting the foot arch and stabilizing the ankle. Tendinitis occurs when the tendon becomes irritated and inflamed, usually due to foot deformities, fallen arch, overuse, or traumatic injury.

Causes of Posterior Tibial Tendinitis

Common causes include:

Overuse: Repetitive and high-impact activities, such as running, especially on hard or inclined surfaces, can cause continuous stress on the posterior tibial tendon.
Traumatic injuries: Ankle sprains or contusions can lead to tendon inflammation.
Biomechanical misalignment: Alignment problems in feet, such as flat feet or postural deviations, can overload the posterior tibial tendon.
Inadequate footwear: Using footwear that doesn't offer proper support can contribute to tendinitis, especially in activities requiring ankle stability.

Symptoms of Posterior Tibial Tendinitis

Typical symptoms include:

Localized pain: Pain on the inner side of ankle/foot and lower leg, which can worsen with physical activities or tendon palpation.
Swelling: Mild swelling around the posterior tibial tendon, especially in the inner ankle region.
Stiffness: Sensation of stiffness and discomfort in the inner leg and ankle, particularly after periods of inactivity.
Tenderness: Sensation of tenderness when touching the affected tendon area.

Diagnosis of Posterior Tibial Tendinitis

To diagnose this condition, doctors use:

Physical examination: Assessment of pain, tenderness, and swelling on the inner side of ankle and leg. The doctor may perform specific tests to evaluate tendon functionality and response.
Imaging Tests: Ultrasound or magnetic resonance imaging (MRI) can be used to visualize inflammation and condition of the posterior tibial tendon, and rule out other possible injuries.

Treatment of Posterior Tibial Tendinitis

Treatment can vary according to tendinitis severity and response to initial treatment:

Conservative: Includes rest, ice application, and use of non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation. Physical therapy is recommended to strengthen muscles around the ankle and improve posterior tibial tendon flexibility.
Activity modification: Reducing or modifying activities that cause tendon stress can help recovery. Low-impact alternatives, such as swimming or cycling, may be suggested.
Appropriate footwear: Use of footwear that offers good support and, if necessary, custom orthotics or insoles to correct biomechanical problems and relieve load on the tendon.

Prevention of Posterior Tibial Tendinitis

Some preventive measures include:

Strengthening and stretching: Perform regular exercises to strengthen muscles around the ankle and stretch the posterior tibial tendon.
Warm-up and technique: Do proper warm-up before physical activities and adjust running technique or other sports to avoid excessive tendon stress.
Appropriate footwear: Use appropriate footwear that offers proper support and cushioning to reduce impact on the tendon.

Conclusion

Posterior tibial tendinitis can cause significant pain and discomfort in the inner side of ankle and leg. Identifying symptoms early and seeking medical evaluation are essential steps for effective treatment. With proper treatment and preventive measures, most people can relieve pain and recover normal tendon function, safely returning to their daily and sports activities.