The tibialis posterior tendon passes down from the muscle at the back of the leg, inside the ankle and under the foot. It plays an important role in supporting the arch during weight bearing activities and overuse can cause injury or degeneration of the tendon.
What causes it?
It is thought to be caused by repetitive stress and small injuries to the tendon usually due to a sudden increase in activity. It is common in distance runners and sports with high volumes of repetitive load to the ankle, particularly older female athletes but does occur in younger athletes as well. Tendinopathy is also seen commonly in the sedentary population, generally in conjunction with significant weakness of the lower limb and excessive weight. Various contributing factors include older age, poor biomechanics and/or weakness of the muscles of the leg, being overweight, wearing unsupportive footwear and spending long periods of time standing, walking, or running.
What are the symptoms?
Pain on the inside of the ankle which may also radiate along the length of the tendon, under the arch of the foot. It can be tender to touch and rolling the foot inwards (inversion) against resistance or performing a single leg heel raise will usually be weak and/or painful. With more mild cases, it may be sore on initial loading and then “warm up”, in more severe cases it can get progressively worse with increased loading. Symptoms tend to flare up in the hours following the activity and can persist until the next day.
How to Treat It?
Early-stage management when symptoms are more acute generally involves relative rest from the aggravating activities, icing, taping or bracing to offload the tendon. Anti-inflammatory medication may also be helpful in alleviating symptoms.
A change in footwear can also make a considerable difference to symptoms. A stability running shoe and orthotics that provide passive support to the to the arch of the foot will also take some of the strain off the tendon. A progressive strengthening program for the ankle and foot muscles is very important for recovery. Also strengthening the leg and hip will help to address areas of weakness which may be causing increased load on the tendon when walking or running and your physio can guide you through a graded return to sport plan.
Stop putting up with pain and decreased function! If you feel like you may have suffered injury to your tib post tendon, make an appointment with one of our expert physios today to get a plan to get you back In Balance and doing the things you love!