Posterior Tibialis Dysfunction
The posterior tibialis tendon attaches the calf muscle to the bones on the inside of the foot. Its main function is to hold up the arch and support the foot when walking. It is therefore one of the most important tendons in the leg and any dysfunction will cause problems. If the tibialis becomes inflamed or torn the tendon may not be able to provide stability and support for the arch of the foot resulting in flat feet.
The most common location of pain is along the course of the tendon itself which travels along the back and inside of the foot and ankle. There may be swelling in addition. The pain is likely to be more severe with activities such as running.
In reaction to the collapse of the foot the heel bone may shift and this can put pressure on the outside ankle bone leading to pain in this new location.
An acute injury such as a fall can tear the posterior tibial tendon. The tendon can also tear due to overuse. High impact sports like tennis, basketball or soccer may cause tears due to repetitive stress.
Initial treatment may require rest and immobilisation. To help the tendon to rest and for any swelling to go down a cast or walking boot may be prescribed for 6-8 weeks.
Following this period of rest bespoke insoles are the most common non-surgical treatment for those who present with moderate or severe changes to the shape of the foot.
In addition an ankle brace can be used to support the joints of the back of the foot and reduce tension in the tendon itself.