Posterior Tibial Muscle Tendon Dysfunction

The posterior tibial muscle performs several essential functions which allow for foot movement and the support of the plantar arch during walking. This crucial muscle is located deep behind the leg, passes under the medial malleolus of the ankle and its tendon ends its course on most of the bones of the middle of the foot. Its action slows down the flattening of the arch of the foot, which is necessary for good shock absorption and helps generate the energy necessary for propulsion.

Posterior tibial tendon dysfunction is a complex term to explain that tendonitis, if poorly treated, will lead to tendon degeneration and cause micro-tears. When the tendon fails, it can no longer fulfill its role and places considerable stress on the internal structures of the ankle and rear-foot. Over time, damage to the ligaments and joints will cause the foot to begin to collapse and gradually become completely flat.

The flattening of the arch of the foot is necessary in order to absorb shocks when walking or running. However, when this flattening lasts too long, the arch of the foot does not return to its proper height position. So what are the disadvantages of flat feet? There are repercussions on all the lower limbs, including inflammation of the membrane that covers the bones, the hardening of the epidermis, bunions, ankle pain, arthritis, etc. These problems can significantly reduce your quality of life, especially if you’re an athlete. Posterior tibial tendon dysfunction and flat feet must be treated at the source before the situation worsens, as this area is constantly stimulated, especially if you’re returning to sports after a period of time off and weight gain.

Posterior Tibial Tendon: Symptoms of Tendonitis

A few of the signs to watch for are sore feet and ankles when standing and feet that seem to collapse over time. See your podiatrist if the first and last steps of your day are strangely more painful than usual and climbing stairs becomes troublesome. Don’t delay in getting a diagnosis and a treatment plan if you notice unusual tightness or pain in your ankle, swelling around the ankle or under the arch of your foot or a throbbing sensation after exercise.

Tibial Tendon Dysfunction: Diagnosis and Treatment

A clinical examination showing a collapsed foot and an inability to stand on your tiptoes without pain will lead to more specific tests to confirm the suspicion. An ultrasound will be necessary to detect alterations in the tendons, ligaments and joints.

If the condition is caught in time at stage one, the probable treatment will focus on protecting and strengthening the tendon of the posterior tibial muscle to prevent permanent collapse of the plantar arch and reduce pain. You’ll be given a home exercise plan and, if necessary, a referral for physiotherapy. Your podiatrist may recommend fitting shoes for flat feet, arch support orthotics, or heel pads that raise the heels by at least 1 cm. Complete rest and cortisone injections are rarely the best solutions, unless there is a serious collateral injury. Stretching and strengthening exercises, ankle braces and taping are usually prioritized. If the level of dysfunction is more severe, shin splints or even reconstructive surgery may be considered. 

In short, beware of flattening feet!