Posterior Tibial Tendon Dysfunction

Posterior tibial tendon dysfunction is a condition that results from the tearing or overstretching of the posterior tibial tendon. This tendon runs from the calf to the arch of the foot. When functioning correctly, the posterior tibial tendon holds up the arch of the foot and supports the foot while the person is walking.

This condition mostly affects women over fifty years of age. Obesity, hypertension, diabetes, and inflammatory diseases are risk factors for developing posterior tibial tendon dysfunction. Previous local steroid injections and previous surgery or injury increase a person’s risk for this condition. Athletes are at risk for tearing the posterior tibial tendon.

Injury to the posterior tibial tendon can cause pain and swelling of the ankle. It can lead to the gradual loss of the arch of the foot, eventually leading to the person becoming flatfooted. The person with a compromised posterior tibial tendon may experience difficulty standing on their toes. Besides pain in the ankle, the individual may experience pain in the middle of the foot, especially during activity.

If left untreated, this disorder can lead to arthritis and an increase pain. There are a number of treatment options. An x-ray, ultrasound, or magnetic resonance imaging (MRI) could be ordered to help the doctor diagnose the condition. After an examination, the doctor can recommend the best treatment based on how far the condition has progressed.

Noninvasive treatment can involve rest, anti-inflammatory medication, and possibly a cast or splint to protect the tendon from overuse. Various surgical methods are used to treat posterior tibial tendon dysfunction. A tendon transfer consists of the surgical transplantation of some fibers from one tendon to repair the damaged posterior tibial tendon. Lateral column lengthening is a recreation of the arch of the foot. A tenosynovectomy is a procedure that includes the removal of the inflamed tissue in the area of the damaged tendon.