Posterior Tibial Tendon Dysfunction
Posterior tibial tendon dysfunction refers to a chronic condition in which a collapse of the mid-foot arch develops. Another name for this condition of acquired flat foot deformity.
Posterior tibial tendon dysfunction results from weakening of the tibialis posterior muscle and tendon. This muscle and tendon originates along the back of the lower leg and attaches to the inside aspect of the foot. When this muscle and tendon weaken, they can no longer help support the arch of the foot. Pain can develop as this disease process progresses.
Aside from pain along the inside of the foot and ankle, collapse of the mid foot arch resulting in flat foot deformity occurs. Inability to stand on your toes also develops.
The underlying cause of posterior tibial tendon dysfunction can be from a tendon abnormality or from overuse. Other risk factors for the development of posterior tibial tendon dysfunction include rheumatoid arthritis, history of previous injury/trauma, obesity, diabetes, or as a result of having cortisone injections to this area. This condition occurs commonly in females over the age of 50.
Non-surgical Treatment for posterior tibial dysfunction includes activity modification, non-steroidal anti-inflammatory medications (NSAID), physical therapy, and changes in shoe wear. More advanced bracing or specialized orthotics may be used for more complex cases of posterior tibial tendon dysfunction.
Surgery may be required in cases of continued pain and collapse of the foot. Surgical techniques range from arthrodesis of fusion of the foot/ankle bones to tendon transfers, osteotomies, and tendon lengthening.