Post Tib Tendonitis Overview and Definitions

Post-Tib Tendonitis (also called posterior tib tendonitis or post tibial tendonitis) refers to damage of the posterior tibial tendon, usually arising from strain. The part running along the foot and the inside of the ankle is called the post-tibial tendon. In some cases, this tendon fails to hold the arch up, causing flat footedness that can eventually cause arch pain, heel pain, plantar fasciitis, and sometimes, heel spurs.

Post Tibial Tendonitis Signs & Symptoms

Posterior tib tendonitis is often characterized by inflammation of the tendon. The more obvious symptom, though, is pain in the instep region of the affected foot. In some severe cases, the inflammation may actually case the tendon to rupture, causing a very identifiable post tibial tendonitis deformity – overpronation or flat foot.

Causes & Risk Factors

Post-tib tendonitis is primarily caused by overuse and strain. In some cases, deformities such flat footedness also lead up to problems in the post tibial tendon. In its initial stages, inflammation caused by posterior tib tendonitis usually comes and goes rapidly. Over time, though, the condition worsens and becomes permanent.

Tests & Diagnosis

Post-tib tendonitis is typically diagnosed using simple physical examination, as the symptoms are apparent. There are some difficult cases that require MRI scans, though, which are effective in verifying if the tendon is already torn.

Post Tibial Tendonitis Treatment Options

The type of posterior tib tendonitis treatment a doctor administers is usually dependent on the severity of the condition. Most doctors advise patients to try orthotic devices first (such as arch support contraptions and specially-designed footwear). Many patients who religiously comply with wearing only orthotically-sound footwear that have adequate cushioning and shock absorption are able to manage their post-tib tendonitis and live normal, comfortable lifestyles.

Most patients are also advised to rest or at least decrease activities involving walking, standing, or running. The rest period will depend on the severity of the case. When the affected area is swollen, anti-inflammatory drugs such as aspirin and ibuprofen are usually recommended. In the longer term, patients may need to alter their exercise routines (if the condition is caused by overuse from working out). The variety helps make sure that certain muscles of the feet are not always under constant stress.

Post Tib Tendonitis Surgery

More serious posterior tib tendonitis cases sometimes warrant surgery. During surgery, the thickened tissue in the affected tendon’s surrounding area is removed in efforts to lessen pain and also to put off possible tendon rupture.
In cases when the tendon has already been torn (ruptured), surgery may be able to repair the damage. Note, however, that most types of ruptures – especially those that are already old – are not repairable. Only new (recently-incurred) ruptures can be repaired by surgery.

In cases when repair is not anymore possible, surgery can be used to replace the damaged tendon with a tendon graft. The tendons that bend down or flex the four smaller toes are usually used as replacement tendons or tendon grafts. They effectively replace and take over the functions of the post tibial tendon.
Posterior tib tendonitis cases that have been neglected for a long time can sometimes cause fixed flat footedness. This deformity can be fixed with an arthrodesis (more commonly referred to as fusion). The joints are fused to lessen pain and enhance stability in the feet.

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