The tibialis posterior tendon goes through the rear part of the leg and beneath the foot. Any form of injury or degeneration of the tendon will instigate pain on the interior of the foot which can radiate along the length of the tendon.
What are the symptoms?
The symptoms typically include pain on the interior of the foot that can radiate throughout the length of the tendon beneath the foot. The creaking sensation known as crepitus can be felt when the tendon moves. The pain is aggravated by passive eversion or inversion with resistance. If the doctor turns the foot outwards to stretch the tibialis posterior or if the individual turns the soles of the feet inwards as the doctor resists to stress out the tendon, pain is triggered.
A close look on tibialis posterior tendonitis
It is important that this condition is an overuse injury and considered as a degeneration of the tendon instead of acute inflammation. There might be partial avulsion in which the tendon pulls away from the bone at the attachment to the navicular bone.
When it comes to long-term injuries to the tibialis posterior, it can result to insufficiency of the muscle and called as tibialis posterior dysfunction that can lead to fallen arches or flat feet.
The possible causes why tibialis posterior tendonitis develops usually include extended stretching of the foot along with the ankle into eversion as well as biomechanical issues of the foot such as over pronation in which the foot rolls in or flattens out as it is in contact with the ground.
You have to apply an ice pack to minimize the inflammation and pain. Remember that the ice pack should not be applied directly on the skin but covered in a damp tea towel. The commercially-available hot and cold packs are usually convenient. The ice pack must be applied at 10 minutes every hour for the initial 24-48 hours if the tendon is sore or inflamed. Later after the acute stage, heat is more beneficial. If you want to learn more on how to effectively provide cold and heat therapy, register for a first aid and CPR class. (Read here for more information about the classes).
Once the pain is tolerable, stretching for the tibialis posterior muscle as well as the calf muscles must be done.
When to consult a doctor
In most cases, electrotherapy such as ultrasound can reduce inflammation and pain. The doctor will recommend anti-inflammatory medications particularly ibuprofen on a short-term basis to reduce inflammation but it cannot help on a long-term basis. It is vital to consult with a doctor before any medication is taken and ibuprofen must be avoided by individuals who have asthma.
Cross friction massage techniques can be used on the tendon while deep tissue massage is usually performed on the calf muscles and tibialis posterior muscle to improve the flexibility and overall functionality of the muscles.
A sports injury professional will provide the ideal rehabilitation program to help reinforce the ankle, particularly the tibialis posterior muscle. Orthotics are usually prescribed and tailored if needed to modify poor foot biomechanics. In case the tendon is ruptured, it should be repaired surgically.