Tibialis Posterior Dysfunction

This is a condition that affects the foot and ankle. It occurs when the posterior tibial tendon is torn or becomes irritated and inflamed. Tendons are what attach bones to muscle, and this specific muscle attaches to bones on the lower side of the foot.

This condition affects mainly women, people older than 40 years of age and
people who play in high energy sports.

• Overuse – As mentioned earlier, people in high energy demanding games like soccer, rugby and basketball at times fall prey to this.
• Minor Trauma – E.g falling, can also cause the posterior tibial tendon to either be inflamed or tear. Once the tendon is inflamed, the arch in the ankle minimises.

• Ankle pain, usually when stepping down.
• Difficulty with activates requiring high energy
• Patients may be unable to stand (even on one foot – standing on tiptoes), walk or run for long distances.
• One may feel pain on the inner parts of the foot. This is where the tendon is, and it may at times be associated with swelling.

Some of the standard tests for flatfoot are

• “Too many toes” – This, of course, is not literally. Looking at the toes from behind, one can see either one-and-a-half to two toes.
• Double leg heel rise – The affected foot is not able to bend inwards at the heel when someone stands on tiptoes. Walking on tiptoes is also very painful.

Stage 1: Inflammation or tendon damage.
Stage 2: Tendon becomes longer, weaker. The arch at the ankle flattens, and patients at this stage cannot do a single heel stand.
Stage 3/4: Partial or full tendon rupture leading to permanent damage.

• Rest in the initial stages helps start the healing process. This includes decreasing activities which put much pressure on the foot and instead of doing activities that don’t require as much force to go through the foot such as swimming.
• Placing ice on the painful parts of the leg for 20 minutes can keep the inflammation down and help relieve the pain.
• Exercise and physiotherapy help strengthen and heal the tendon including the muscle.
• Consult your GP regarding medications
• Orthotics and shoe inserts can help elevate the foot, and alleviate the stress on the muscle to give it a chance to heal.

If all else fails and symptoms persist, surgery may be an option; however, this depends on the extent of damage to the tendon.
Cleaning the tendon. This method is useful when the damage is not as major, and the foot’s shape is still the same. The surgeon removes the inflamed material from the foot.

Check out the videos below for some more information

What is Tibialis Posterior Dysfunction
Exercises to manage Tibialis Posterior Dysfunction

Ensure you are not worsening it by seeking treatment as soon as possible.
Conservative measures can help treat this condition when detected early.

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