What is Post Tib Tendonitis? Transcript
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Hello, I’m Donna Robertson, Head of Training and Chief Pedorthist for Foot Solutions, a foot wellness retailer specializing in expertly fitted footwear and custom crafted orthotic insoles. Today we are going to discuss a common foot pathology known as Posterior Tibial Tendonitis , better known as Post-TibTendonitis. The posterior tibial tendon originates inside of the lower leg and runs down the area just behind the medial ankle bone and attaches in the middle of the medial arch. The main attachment point is at the base of the navicular bone, where the tendon fans out to attach to other bones in the bottom of the midfoot. The posterior tibial tendon is one of the main structures which maintains and supports the arch. When the posterior tibial tendon is not functioning properly, the arch is not maintained and will eventually collapse. This is a sign of loss of muscle tone, muscle function, ligament laxity and joint instability causing the posterior tibial tendon to become overworked. The result is microtears, inflammation and the development of tendonitis. The two most common locations of pain are at the insertion of the tendon on the navicular bone and inside just behind the ankle. Posterior tibial tendonitis is generally associated with flatfeet. But the cause is not simply an arch collapse. The development of posterior tibial tendonitis and the associated flatfoot (adult acquired flatfoot) is due to abnormal foot biomechanics. Most individuals with posterior tibial tendonitis have an abnormal amount of pronation. The foot is flexing up at the ankle, the forefoot is turning out away from the midline of the body and the heel is rotating out, away from the midline of the body leading to over pronation. The tendon eventually weakens, resulting in referred knee/hip pain added to the original foot pain as the arch continues to collapse. The posterior tibial tendon controls eversion of the ankle and the amount of pronation occurring in the foot. Once the heel rotates out, the midfoot starts to collapse and excess stress is placed on the posterior tibial tendon at the ankle area and at the insertion. For individuals with abnormal pronation, the tendon is constantly under abnormal stress during activity and something as simple as a shoe style change for walking or running can stimulate the development of overuse tendonitis. The symptoms of post tib tendonitis are as follows: Heel pain, Arch pain, Ankle pain, Plantar fasciitis, Heel spurs, and Metatarsal pain. With post-tib tendonitis, pain will be more severe upon weight bearing, especially while walking or running, which is why it is important to find the proper foot including shoe selection and supportive insoles. Post-Tib Tendonitis occurs when the muscle is overused and the tendon (soft tissue) that connects the muscle to your bone is strained. With Posterior Tibial Tendonitis, the tendon does not function to hold up the arch, resulting in a lower arch leading to flat feet. Years of over-pronation (flat feet) can also lead to posterior tibial tendon dysfunction. Continued overuse and lack of arch support for the muscle/tendon insertion, leads to tendon damage and tendonitis develops. At first the pain or swelling may come and go quickly, but eventually the problem may become more permanent. In a follow up video, we will discuss treatment of Post-tib tendonitis and how Foot Solutions can help alleviate the issues associated with this pathology. To learn more or to schedule a visit with one of our in-store Pedorthists, visit www.footsolutions.com. Your feet are the foundation of your health. Let us take care of them for you.
