Posterior Tibial dysfunction is associated with the loss of function of the Posterior Tibial Muscle resulting from a repetitive strain or overuse of this muscle. The Posterior tibial muscle is the main muscle which supports the arch of the foot.
Main contributing factors
- Repetitive activity or motion that causes strain on the muscle and tendon
- Direct Trauma
- Poor foot structure causing excessive midfoot collapse
- Tight calf muscles
- Inflammatory processes such as Rheumatoid Arthritis
- More prevalent in Females over the age of 40 years
- Sudden increase in activity level
- Increased BMI
- Diffuse swelling on the arch of the foot
- Tenderness and warmth on the medial side of the ankle along the course of the tendon
- A gradual loss of the arch of the foot
- Excessive heel wear on the medial side of the shoes
- gait can become unsteady
- Difficulty rising onto the toes
Treatment for Posterior Tibial Tendon Dysfunction
- RICE – rest, ice, compression & elevation
- Non-steroidal anti-inflammatory drugs (Nurofen etc)
- Activity modification or reduction
- Footwear modification
- Orthotic therapy for long term repositioning of the foot.
- Possible immobilization in casts or walking boots
- Muscle strengthening exercises
What can you do?
- Reduce or modify current activities
- Gradually resume normal activity as symptoms resolve
- Ice after training/ activity 15 minutes on, 2 hours off, 15 minutes on
- Footwear assessment – it may be time for a new pair
- Eccentric strengthening of the posterior tibial muscle.