Posterior Tibial Tendonitis

Has there been a silver lining to the Covid 19 pandemic? It’s hard to believe that there could possibly be any , but we’ve observed a noticeable increase in walkers, bikers and golfers over the past several months so in that respect people are trying to be healthy. Along with the increased activity , however , is the possibility of exacerbation of inherent foot disorders and pain . One problem in which I am very familiar, having suffered with the condition for several years myself is called posterior tibial tendonitis. This tendon originates in the leg and courses around the side of the ankle bone into the foot to help support the arch . It is possible that the tendon can become inflamed and , in the worst case, stop working correctly to allow a slow collapse of the arch. This can occur particularly in older or active people. Milder cases produce pain without an arch collapse. Walking becomes painful.
The posterior tibial tendon is the only tendon that has a major role in supporting the arch . There are ligaments that bind the bones in the foot together but this tendon actively pulls up the arch in weight bearing and exercise.


Home exercises

There are specific exercises to strengthen this tendon. One is called the A to Z strengthening exercise. To do this you would cross your leg and suspend your foot in front of you while sitting in a chair. With your big toe being the pointer write the alphabet in capital letters rotating your ankle writing all letters from A to Z. Start with small letters and progress to larger letters. Do this twice a day.

A second exercise is to stand with both feet together and raise your heel up off the ground holding on to something for support if necessary. Raise up at least 30 repetitions and do this twice a day. Despite your best efforts to prevent problems with your arch and this tendon you might need additional professional care.

In mild conditions which is manifested by pain in the inside of the ankle and into the arch , the condition can be treated with ice massage, more supportive (or new) shoes, over the counter arch supports, and an anti-inflammatory. More advanced cases may need rest, boot immobilization for several weeks followed with specific custom orthotics or cast/SCAN made from a cast of your foot by your podiatrist. In even most advanced-end stage cases a custom made foot and ankle brace can be made. As both a podiatrist and a patient with this condition, I can attest to all the above treatment plans and devices- the devices are used at different times and days. So there is hope! No need to hobble around in pain . Consult your podiatrist for a more customized treatment plan.


Dr. Richard Miller works in our Charlotte, NC (South Charlotte) and Charlotte, NC (Myers Park) offices for your convenience.

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