What is Posterior Tibial Tendon Dysfunction And How To Treat It Effectively?

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Post-tib tendonitis is a complication that affects the foot and the ankle. It occurs when the posterior tibial tendon is affected by issues such as tearing or inflammation due to excessive pressure. The inflammation may affect the stability and ability of the arch of the foot to provide support. Usually, the condition can be treated using various approaches such as braces, orthotics, surgery, and more. The post tibial tendon is a vital aspect of the foot. It consists of a tendon that connects the muscles to the bone, whereby it provides support the foot as you walk.

Patients will complain of various issues such as pain in the foot, weakness, and decreased foot functionality. Using techniques such as X-ray, magnetic resonance, and more can help classify the condition and on the choice of management. The ideal treatment process relates to the progression of foot deformity and more. Being able to identify the post-tib tendonitis early can help to stop the development of the condition.


There are various causes of a post-tib tendonitis injury. Usually, the injury comes up as a result of issues such as high impact forces from falls. Furthermore, the injury can come up as a result of overuse of the tendon section of the feet. For instance, people who engage in high levels of physical activity such as professional sportsmen. Once the tendon becomes inflamed or experiences tears, then the arch tends to collapse, and it might even cause pain. The condition is common among women and individuals over the age of 40. Other common risk factors of the health condition include diabetes, hypertension, and obesity.


The range of symptoms associated with the condition are many. Usually, people will complain about the following issues:

  • Pain in the interior section of the foot, where the tendon sits. The pain might also have accompanying problems such as inflammation around the affected area.
  • Pain in the foot that increases when you engage in high levels of physical activity such as running. Some patients might face issues in walking or moving around.
  • Pain on the exterior section of the ankle. Once the foot collapses, the heel bone might move to a new position. This type of unusual movement can place pressure on the exterior section of the bone.


The diagnosis process of a pot-tib tendonitis injury varies in many ways. Usually, the process will involve the following steps:

Staging of the Foot Deformity

Being able to stage the post-tib tendonitis effectively is crucial in the treatment process. For some patients, both non-invasive and invasive treatment options might be required. More so, the treatment options vary with each successive stage of the disease. The main stages in the post tib tendonitis progression include:

  • Stage I – the posterior tendon is intact and experiences inflammation. However, the foot does not have any deformity and the individual experiences mild swelling
  • Stage II – the patient suffers visible changes in the structure of the foot due to attenuation in the tendon and decrease in function. Furthermore, the patient might experience challenges in movement or fail to perform a single heel rise.
  • Stage III – the toe deformity becomes rigid, and the patient is unable to perform a single heel rise due to the weak muscles. This stage might involve the use of radiographs to reveal any changes occurring in the structure of the foot.
  • Stage IV – the foot has experienced a complete rupture in the muscles, and it becomes an entire foot deformity. The condition at this stage is often accompanied by issues such as extreme pain and decreased mobility in the foot.

Medical History Evaluation and a Physical Exam

The doctor will start with evaluating your medical history and ask some few questions relating to the foot injury. More so, he might also check for the presence of the following symptoms:

  • Inflammation along the affected area. Usually, the swelling starts from the lower leg up until the interior section of the foot.
  • A significant change in the shape and structure of the foot. More so, the heel may also tilt outward, and the arch may even collapse. Such patients usually require advanced treatment procedures such as reconstructive surgery.
  • Lack of the ability to stand stable on one leg, which requires a health tibial tendon. A patient that can’t stand one leg and raise a heel indicates an issue with the posterior tibial tendon muscle.
  • Decreased flexibility is also another symptom if the patient cannot move his foot from one side to side. The treatment plan for limited flexibility changes in regards to the nature of the injury.
  • Pain in the affected area is also a common sign of foot health complication. Any pain when moving around or engaging physical activity indicates a fractured or swollen tendon muscle.

Using Imaging Tests

The foot health medical professional might also perform various other types of tests on the foot.  These main goals of these test is to provide a better image of the affected foot area. They might include:

  • X rays – these are special imaging test that provides a detailed perspective of the dense structures in the foot such as the bone. The x-ray makes it easy to determine the nature of damage to the foot.
  • Magnetic Resonance Imaging – these are studies that provide images on the soft tissues in the body such as muscles and the tendon. The MRI is performed when the foot health diagnosis fails.
  • Computerized Tomography Scan CT Scan – these are scans that provide more detail than the conventional x-ray procedure. It helps to differentiate the Post Tib Tendonitis condition form issues such as arthritis which might affect the health of your foot.
  • Ultrasound – designed to high-frequency sound waves that echo from the body, the ultrasound helps to provide a picture of the tissue and bone in the body. While the ultra sound seems advanced, it helps to provide added information for a proper diagnosis.

Treatment Methods for Post-Tib Tendonitis

The management and treatment of posterior tibial tendon dysfunction require an accurate staging of the complication. The staging of the foot deformity involves four main stages. The main reason for the staging is because both invasive and non-invasive treatment options vary with each stage of the disease. Similar to all foot deformities, the goal of the treatment are to control pain, improve functionality, and restore the proper alignment of muscles. Early referrals to an orthopedic or foot specialist are essential. The treatment methods for a post-tib Tendonitis injury are many and different in various ways. Among some of the conventional methods include:

Non-surgical Treatment

Most symptoms associated with the foot health complication will resolve themselves without any surgery. These are techniques that help in pain management and in reducing the average recovery time of the individual.

  • Rest – rest is essential because it allows the individual to rest the affected area, thereby promoting optimal healing and recovery.
  • Ice – using ice helps to manage issues such as pain and inflammation. The ice can be placed on the affected area, particularly when the symptoms flare up
  • Compression – compression helps to restore the original structure of the affected area, while also providing sufficient comfort for recovery.
  • Elevation – elevation allows the individual to place the foot at a strategic position that helps promote recovery and optimal foot comfort.

Non-Steroidal Anti Inflammatory Medication

Consuming various types of drugs helps to control pain and inflammation issues in the body. The common ones for managing foot pain issues include naproxen, ibuprofen, and more. Consuming such medications a few minutes before physical activity helps to control any inflammation around the tendon. However, such drugs are not suitable for curing the condition, but only for managing the pain.

Orthotics and Braces

Using foot health tools such as orthotics and braces are essential in the recovery process for post tib tendonitis health complication. In particular, an orthotic is a type of shoe insert. It is a standard non-surgical treatment for a host of foot health complication. The orthotics help to reduce the pressure around the affected area and to provide added comfort. The orthotics are easily accessible without the need of a prescription. More so, the braces are also equally useful for addressing foot health issues. For instance, a lace-up ankle brace helps elevate the foot and reduce any pressure on the affected area. The brace will also provide support for the joints and the back of the foot.’

Mobility Bands

There are various types of mobility bands that are available on the consumer market. These are excellent solutions for improving the mobilization of the calf tissue and the foot as well. Furthermore, using the mobility bands helps to enhance the flow of blood to the affected area, thereby improving healing. The mobility bands also help to restore the functionality of some of the cells in the muscle tissue that exists in the foot. The use of the band begins at the midsection of the foot, and loops over the ankle. Then, pump the ankle forward and backward in every direction for as many times as possible. However, if you experience any discomfort, then stop the process.

Improve your Balance and Avoid Overtraining

Poor balance is one of the leading risk factors associated with weak muscles in the foot and the entire body. The weakness and muscle balance issues can compromise the biomechanics of the body in many ways. As such, these foot health conditions can lead to excessive strain on sections of the foot, such as the posterior tibialis tendon. Being able to practice balance on one foot is a vital process in restoring the functionality of the muscle. Furthermore, keeping track of the surfaces you use for physical activity is essential. Broadly speaking, softer surfaces are better for the recovery process, especially if you have advanced post-tib Tendonitis.

As far as training goes, keeping track of your physical activity regimen is also highly important. Exposing the affected area to immense stress or pressure can lead to issues such as injury and more. Even more, proper training is vital because it helps to reduce any strain on the already weakened foot muscles.

Wear the Correct Shoes

Putting on supportive shoes and/or boots is perhaps one of the most useful techniques when it comes to taking good care of your feet. When you have post-tib tendonitis, putting on good shoes provides various benefits. A good shoe helps to provide optimal comfort, thereby reducing the recovery time significantly. More importantly, a good shoe ensures that the muscles are not exposed to excessive strain and pressure. The extreme stress and tension is the leading cause of muscle pain as well as tendon issues. A good shoe offers sufficient support for the feet, especially on hard or abrasive surfaces.

Surgical Options

The surgical treatment of posterior tibial tendinitis varies in relation to the nature of the injury, and various other factors. If the condition is still in the early stages, some practitioners might recommend necessary surgical procedures. A good example would be a medical process to help reduce the inflammation, otherwise referred to as a debriment. However, the advanced cases of post tib tendonitis might require more. For instance, such feet often consist of a collapsed or damaged tendon, which might require a complete transfer. During the reconstructive procedure, the doctor might use a neighboring tendon to replace the damaged section of the foot. In some cases, the surgery is implemented along with a bone reconstruction procedure.


Foot health complications are common, and they can have adverse effects on your day to day schedule. Post-tib tendonitis occurs when specific muscles in the feet suffer from inflammation, pain, and more. Being able to prevent and treat such as foot health complications requires informed decisions making. For instance, managing post-tib tendonitis requires an accurate staging of the health condition. You need to ensure that you keep wearing proper shoes and be able to identify the disease in its early stages. Surgery is only considered as an option in the advanced where the individual has suffered extensive bone and muscle damage.

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