Posterior Tibial Tendonitis
Tendons are strong cords of tissue that connect muscles to bones, including several in the foot and ankle. The posterior tibial tendon connects the muscle in the back of the calf to the bones in the foot and helps support the arch of the foot when walking or running.
Posterior tibial tendonitis, also known as posterior tibial dysfunction disorder or PTDD, occurs when this tendon becomes damaged or inflamed. Untreated, it can lead to arthritis of the ankle, the loss of some foot function, flat feet, and other foot and ankle deformities.
Schedule an Appointment
The orthopedic specialists at University Hospitals have the advanced skills and experience to treat all foot and ankle conditions, including posterior tibial tendonitis. To schedule an appointment, call 216-220-9088 or schedule online.
Causes & Symptoms of Posterior Tibial Tendonitis
Posterior tibial tendonitis is more common in women than men and typically affects people over the age of 40. Additional risk factors include obesity, overuse in high-impact sports, and history of a recent ankle injury or sprain.
Symptoms of a damaged injured or inflamed posterior tibial tendon may include:
- Tenderness and swelling over the back, inside part of the ankle.
- Pain when standing or flexing the foot.
- Pain or weakness with ankle motion or attempting to stand on tiptoe.
- Crackling sounds when the tendon is moved or touched.
Individuals experiencing any of these symptoms should be evaluated by an orthopedic specialist as soon as possible to avoid long-term complications. In some cases, surgical repair may be necessary.
Diagnosing Posterior Tibial Tendon Dysfunction (PTTD)
Your doctor will take a complete medical and lifestyle history and conduct a physical exam. If PTTD is suspected, an MRI scan may be done to look for inflammation around the tendon and determine if and where it has ruptured.
Based on the medical evaluation and imaging exams, a diagnosis of PTTD will be classified as stage 1, 2, 3 or 4. Stages are assigned based on the severity of symptoms and the extent of foot and ankle deformity or disability. Advanced stages often require more extensive treatment, including surgery.
Conservative, Nonsurgical Treatments
If diagnosed at an early stage, posterior tibial tendonitis can often be treated with conservative, nonsurgical approaches. These may include:
- Rest, elevation and icing. Even walking is discouraged because it can prevent healing.
- Immobilization. The foot and ankle may be fitted with a brace, cast, custom orthotic or medical boot.
- Medications. Nonsteroidal anti-inflammatory medications (NSAIDs) may be recommended to reduce inflammation around the tendon.
- Physical therapy. Stretching and strengthening exercises combined with therapeutic massage.
- Cortisone shots. Steroids injected around the tendon to reduce inflammation and pain.
Surgical Treatment of Advanced or Chronic PTTD
If conservative measures don’t resolve symptoms after several months of treatment, your orthopedic specialist may recommend surgery. If an acute injury or rupture of the tendon has occurred, surgical repair might be needed immediately.
During surgery, an incision is made in the back of the calf to either remove or repair the damaged portion of the tendon. If the damage is severe and a large portion of the tendon needs to be removed, a tendon may be taken from elsewhere in the foot to make the repair.
This operation is done under general anesthesia in a hospital or an outpatient surgery center and most patients go home the same day.
Make an Appointment
Our orthopedic experts offer in-person and virtual visits. Call 216-220-9088 or schedule your visit online today.