Posterior Tibial Tendonopathy

(Posterior Tibial Tendonitis; Posterior Tibial Tendonosis)

Definition

Tendonopathy is an injury to the tendon. It can cause pain, swelling, and limit movement. The injuries can include:
  • Tendonitis—an inflammation of the tendon
  • Tendonosis—tiny tears in the tendon with no significant inflammation
The posterior tibial tendon runs from the posterior tibial muscle to the inside of the ankle and the arch of the foot. The main job of this tendon is to support the arch of the foot. If the tendon is injured or weak, then the arch of the foot can collapse. This will make the foot pronate, or roll inward. These injuries can make it painful to walk.Treatment depends on the severity of the tendonopathy.
Tendonitis
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Causes

Causes of posterior tibial tendonopathy include:
  • Overuse of the tendon
  • Poor blood supply to the tendon
  • Biomechanics that cause degeneration of the tendon, such as over pronation of the foot

Risk Factors

Posterior tibial tendonopathy is more common in women and in people over the age of 40 years. Other factors that increase your chance of posterior tibial tendonopathy include:
  • Flat feet
  • Obesity
  • Diabetes
  • High blood pressure
  • Previous surgery or trauma
  • Local steroid injections

Symptoms

Symptoms may include:
  • Pain and swelling near the arch of the foot and on the inside of the ankle
  • Pain that increases when standing on the ball of the foot or if the foot is flexed
  • Pain that increases with activity
  • Tiredness in the foot after little activity
  • Pain that becomes more disabling
  • Later in the course of the tendonopathy, a flattening of the arch of the foot and pronation
  • An inability to push off well when running

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