What is Posterior Tibial Tendinitis?

Understanding the Pain Behind the Arch and Ankle

Posterior tibial tendinitis is a common condition that causes pain along the inside of the ankle and foot, often accompanied by swelling or difficulty walking. This condition arises when the posterior tibial tendon, which supports the arch of the foot, becomes inflamed or torn. The tendon plays a crucial role in stabilizing the foot and maintaining its arch during movement. When this tendon is compromised, it can lead to flatfoot deformity or progressive foot pain.

At Gotham Footcare, we specialize in diagnosing and treating posterior tibial tendinitis to help patients regain their mobility and prevent complications.

Causes of Posterior Tibial Tendinitis: Why Does the Tendon Get Injured?

Overuse and Repetitive Stress

The posterior tibial tendon can become inflamed or torn from repetitive activities that place strain on the foot, such as running, hiking, or prolonged standing.

Trauma or Injury

Acute injuries, such as a sudden twist or impact, can damage the tendon, leading to inflammation and pain.

Flat Feet

People with flat feet are at higher risk of developing posterior tibial tendinitis due to the increased strain placed on the tendon to support the arch.

Aging and Degeneration

As people age, the tendon can weaken and degenerate, making it more susceptible to tears and inflammation.

Chronic Conditions

Underlying conditions such as obesity, diabetes, or rheumatoid arthritis can increase the risk of tendon damage by placing excessive stress on the posterior tibial tendon or affecting its integrity.

Symptoms of Posterior Tibial Tendinitis: How to Recognize the Condition

Pain Along the Inner Ankle

One of the primary symptoms is pain along the inside of the ankle and foot, which may worsen with activity or prolonged standing.

Swelling and Tenderness

The area along the posterior tibial tendon may become swollen, red, or tender to the touch.

Flatfoot Deformity

As the condition progresses, the arch of the foot may collapse, leading to a visible flatfoot deformity.

Difficulty Walking or Standing

Many patients experience difficulty walking or standing for extended periods due to pain and instability.

Heel Tilts Outward

In advanced cases, the heel may tilt outward, causing an imbalance and altering the way you walk.

Diagnosing Posterior Tibial Tendinitis

How Gotham Footcare Can Help

Thorough Physical Examination

Our podiatrists begin with a detailed examination of your foot and ankle. We check for tenderness, swelling, and alignment issues to assess the health of the posterior tibial tendon.

Gait Analysis

We evaluate your gait and foot alignment to identify changes in movement patterns that may indicate tendon dysfunction or flatfoot deformity.

Imaging Tests

Advanced imaging, such as X-rays, MRI, or ultrasound, may be used to confirm the diagnosis and assess the extent of tendon damage. These tests also help rule out other potential causes of foot pain, such as arthritis or fractures.

Home Remedies for Posterior Tibial Tendinitis

Relieving Pain and Inflammation at Home

Rest and Activity Modification

Avoid activities that exacerbate your symptoms. Giving the tendon time to heal is essential to prevent further damage.

Icing the Area

Applying ice to the affected area for 15–20 minutes at a time can reduce swelling and alleviate pain.

Stretching and Strengthening Exercises

Gentle stretches and exercises to strengthen the posterior tibial tendon can help alleviate symptoms. Examples include:

Calf Stretch: Stand facing a wall, step one foot back, and keep your heel on the ground. Hold for 20–30 seconds and switch sides./li>
Toe Raises: Stand on your toes and slowly lower your heels back down. Repeat 10–15 times.

Supportive Footwear and Orthotics

Wearing shoes with proper arch support and cushioning can help alleviate strain on the tendon. Custom orthotics may provide additional support and correct alignment issues.

When to See a Podiatrist

Signs Your Condition Requires Professional Care

Persistent Pain or Discomfort

If pain continues despite rest and home care, it’s time to consult a podiatrist for a comprehensive evaluation.

Difficulty Walking or Standing

Severe pain or instability that affects your ability to walk or stand requires immediate medical attention.

Visible Deformity or Changes in Foot Shape

If you notice a flattening of the arch or other changes in foot shape, seek professional care to prevent further complications.

Swelling and Redness

Persistent swelling or redness may indicate a more serious issue, such as a partial tear or infection.

Treatment Options for Posterior Tibial Tendinitis at Gotham Footcare

Non-Surgical Treatments: Conservative Management for Tendon Health

Physical Therapy
Targeted exercises to strengthen the posterior tibial tendon and surrounding muscles can improve stability and reduce pain.

Custom Orthotics
Custom-made orthotics provide arch support and redistribute pressure to alleviate strain on the tendon.

Anti-inflammatory Medications
Oral or topical anti-inflammatory medications can help manage pain and reduce inflammation.

Immobilization
In some cases, wearing a walking boot or brace may be recommended to immobilize the foot and allow the tendon to heal.

Advanced Treatment Options

Platelet-Rich Plasma (PRP) Therapy

PRP injections use your body’s growth factors to stimulate healing and reduce inflammation in the damaged tendon.

Ultrasound-Guided Injections

Corticosteroid injections may be used to alleviate pain and inflammation under the guidance of ultrasound for precise delivery.

Shockwave Therapy

Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment that uses sound waves to stimulate blood flow, accelerate tendon healing, and reduce pain associated with posterior tibial tendon dysfunction (PTTD).

Surgical Treatments: Restoring Function in Severe Cases

Tendon Debridement and Repair

For cases involving significant damage or tearing, minimally invasive surgery to remove damaged tissue and repair the tendon may be necessary.

Tendon Transfer

In advanced cases, a tendon transfer may be performed to replace the damaged posterior tibial tendon and restore foot function.

Flatfoot Reconstruction

For patients with severe flatfoot deformity, reconstruction surgery may be needed to realign the foot and restore arch stability.

Duration of Treatment

How Long Does It Take to Recover from Posterior Tibial Tendinitis?

Conservative Treatments

With proper care, most patients experience relief within 6–8 weeks. Physical therapy and orthotics play a crucial role in recovery.

Surgical Recovery

Recovery from surgery can take several months, depending on the procedure performed. Physical therapy is essential for regaining strength and mobility.

Preventing Posterior Tibial Tendinitis

Tips to Maintain Healthy Tendons

Wear Proper Footwear

Invest in supportive shoes with good arch support and cushioning to reduce strain on the posterior tibial tendon.

Avoid Overuse

Gradually increase activity levels to avoid overloading the tendon. Alternate between high- and low-impact exercises.

Maintain a Healthy Weight

Reducing excess weight can alleviate pressure on the feet and tendons.

Stretch and Strengthen Regularly

Incorporate exercises to strengthen the posterior tibial tendon and surrounding muscles into your routine.

Frequently Asked Questions About Posterior Tibial Tendinitis

What Causes Posterior Tibial Tendinitis?

Overuse, flat feet, and aging are common causes. Trauma and chronic conditions can also contribute to tendon damage.

Can Posterior Tibial Tendinitis Heal on Its Own?

Mild cases may improve with rest and conservative care, but severe cases often require professional treatment.

Is Surgery Always Necessary for Posterior Tibial Tendinitis?

No, most cases are managed with non-surgical treatments. Surgery is reserved for severe or advanced cases.

How Can I Prevent Recurrence?

Wearing supportive footwear, maintaining a healthy weight, and incorporating regular stretching and strengthening exercises can help prevent recurrence.

Your First Step to Getting Better

At Gotham Footcare in NYC, we strive at recognizing your individual needs and desired outcomes while formulating an effective and personalized treatment plan with the highest quality care available.

What sets Gotham Footcare apart from other podiatry offices is our dedication to providing you with the education you need to make well-informed decisions regarding your care. Regardless of what your foot and ankle trouble may be, at Gotham Footcare our team will work tirelessly to help you feel better. At Gotham Footcare, we help you put your best foot forward.

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