Dr. Debra J. Aleck and Associates
3511 Western Branch Blvd.
Portsmouth, VA. 23707
(757) 397-FOOT (3668)
Posterior Tibial Tendon Dysfunction
Glossary
Arch - The arch of the foot is the area of the bottom of the foot between the heel pad and toe pad.
Acrokeratosis verruciformis - a hereditary dermatosis characterized by the presence of numerous flat wart-like papules on the dorsal aspect of the hand, foot, elbow, and knee.
Ankle - the part of the leg just above the foot; the joint between the leg and the foot. It is a hinge joint formed by the junction of the tibia and fibula with the talus, or ankle bone. The bones are cushioned by cartilage and connected by a number of ligaments, tendons, and muscles that strengthen the joint and enable it to be moved. Because it is in almost constant use, the ankle is particularly susceptible to injuries, such as sprain and fracture. It is also often one of the first joints to be affected by arthritis or gout.
Ankle clonus - a series of abnormal reflex movements of the foot, induced by sudden dorsiflexion, causing alternate contraction and relaxation of the triceps surae muscle.
Athlete's foot - a fungal infection of the skin of the foot; called also tinea pedis. It causes itching and often blisters and cracks, usually between the toes. Causative agents are Candida albicans, Epidermophyton floccosum, and species of Trichophyton, which thrive on warmth and dampness. If not arrested, it can cause a rash and itching in other parts of the body as well. It is likely to be recurrent, since the fungus survives under the toenails and reappears when conditions are favorable. Although Athlete''s foot is usually little more than an uncomfortable nuisance, its open sores provide excellent sites for more serious infections. Early treatment and health care supervision insure correct diagnosis and prevention of complications. Specific diagnosis is made by microscopic examination or culture of skin scrapings for the fungus.
The posterior tibial tendon starts in the calf, stretches down behind the inside of the ankle, and attaches to bones in the middle of the foot. This tendon helps hold the arch up and provides support when stepping off on your toes when walking. If it becomes inflamed, over-stretched or torn, it can cause pain from the inner ankle. Over time, it can lead to losses in the inner arch on the bottom of your foot and result in adult-acquired flatfoot.
Signs and symptoms of posterior tibial tendon dysfunction include:
- Gradually developing pain on the outer side of the ankle or foot.
- Loss of the arch and the development of a flatfoot.
- Pain and swelling on the inside of the ankle.
- Tenderness over the midfoot, especially when under stress during activity.
- Weakness and an inability to stand on the toes.
People who are diabetic, overweight, or hypertensive are particularly at risk. X-rays, ultrasound, or MRI may be used to diagnose this condition.
Left untreated, posterior tibial tendon dysfunction may lead to flatfoot and arthritis in the hindfoot. Pain can increase and spread to the outer side of the ankle.
Treatment includes rest, over-the-counter nonsteroidal anti-inflammatory drugs, and immobilization of the foot for six to eight weeks with a rigid below-knee cast or boot to prevent overuse. Note: Please consult your physician before taking any medications.