Definition

Posterior tibial tendinopathy is an injury to the tendon that attaches the calf muscle to the bones on the inside of the foot.

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Causes

Causes of posterior tibial tendinopathy include:

• Overuse of the tendon
• Abnormal body mechanics, such as rotating the foot inward too much when walking
• Trauma

Risk Factors

This problem is more common in women who are over 40 years of age, especially those who are obese. Other things that may raise the risk are:

• Loose ligaments
• High blood pressure
• Diabetes
• Steroid use
• Previous surgery or foot trauma

Risk factors in athletes may be:

• Over-training
• Wearing the wrong sports shoes

Symptoms

Problems may be:

• Pain and swelling on the inside of the foot and ankle
• Pain that increases with activity, such as with running or walking
• Pain on the outside of the ankle

These symptoms may cause the arch of the foot to become flat over time.

Diagnosis

The doctor will ask about your symptoms, health history, and the activities that you do. A physical exam will be done. It will focus on the foot. This may be enough information to suspect the diagnosis.

Images of your foot and ankle may be taken to confirm the diagnosis. This can be done with:

• X-rays
• Ultrasound
• MRI scan

Treatment

The goal is to ease pain, improve motion, and stop or slow the problem from getting worse. This may be done with:

• Ice, rest, and medicine to ease pain and swelling
• Exercises to stretch and strengthen the muscles around the foot and ankle
• A brace, cast, or shoe inserts to keep the foot or ankle from moving

Some people may need surgery to repair the tendon when other methods do not help.

Prevention

It may be possible to prevent this problem by getting early medical care to treat any foot deformities.