Posterior Tibial Tendon Dysfunction is a condition that affects the ankle and the foot as a result of the tearing or inflammation of the posterior tibial tendon, which connects the calf muscles in the leg to the bones on the inner side of the foot. The tendon helps to keep the foot arch intact and provides stability while walking or movement. An injury to the tendon results in loss of stability and gradual development of a Flatfoot. This ailment is found to be more prevalent in women particularly after the age of 40.
Causes
- Injury to the leg or foot resulting in tearing or damage to the tendon
- Sudden fall
- Stress, hypertension, Diabetes and
- Obesity increase the chances of developing this problem
- Sports or high impact activities such as basketball, soccer or tennis may result in repetitive use and consequent tearing of the tendon
Symptoms
- Pain which can get worse with movement or any activity involving walking, running or even standing for long duration
- The patient may develop swelling near the arch of the foot
- Gradual collapse of foot arch
- The outer ankle bone will develop pain with the shifting of the heel bone
- Too many toes will be visible from the rear of the foot due to inward rolling of the ankle
- Change in foot shape
Diagnosis
- Analysis of the patient’s medical history
- Assessment and investigation of the time and process of injury
- Conducting a flexibility test to check the range of motion
- Several imaging techniques may be applied such as X-rays, CT scan, MRI or Ultrasound to analyze the bone and tissue damage
Treatment
- The orthopedic doctor may recommend the patient to rest the injured foot or leg and strict avoidance of activities that pressurize the foot
- Application of ice packs at regular intervals 3-4 times in a day helps reduce swelling
- Prescription of anti-inflammatory drugs or pain killers
- Use of a cast or a special boot to immobilize the leg or to provide additional support to the tendon
- Orthotic devices such as a brace or a shoe insert may help alleviate symptoms of Flatfoot and provides adequate support to the patient
- Surgical methods of treatment depend on the severity of the damage and location of the tendon. The following methods may be adopted:
- Damaged posterior tibial tendon may be removed and replaced by another tendon in the foot to restore function and stability
- Surgical removal of the inflamed tissues around the tendon
- Flatfoot can be treated by lengthening the calf muscles
- Osteotomy, i.e. surgical cutting of one or two bones to repair the
- Flatfoot and create a normal arch shape
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