Download Tibialis posterior tendon dysfunction

Tibialis posterior tendon dysfunction
ALICE GOODEAR – Podiatrist
Tibialis posterior tendon dysfunction is a soft tissue injury that is not widely known within the general
community. The dysfunction can result in foot pain, swelling and flat feet. The tibialis posterior muscle
extends from tibia and fibula (lower leg bones), it then travels down the inside of the lower leg and
ankle (behind the inner ankle bone) where it inserts into various bones in the foot via the tibialis
posterior tendon. It is this insertion into various bones of the foot that is usually affected and results
in severe mid-foot pronation (rolling inwards) and pain upon palpation of the tendon. The tibialis posterior muscle is
responsible for maintaining the foot arch, moving the foot/ankle inwards and pointing the foot/ankle down.
Tibialis posterior tendon dysfunction is a common injury seen in running sports such as football, basketball, hockey and
long distance athletes. Along with overuse, there are other factors that may predispose a person to this type of injury, for
example, poor foot biomechanics, weight, training errors, joint stiffness, muscle weakness (particularly in the calf muscle),
inadequate fitness etc.
Adequate rest along with specific exercise is the best form of recovery for this soft tissue injury. The following exercises
should be also tried to help decrease inflammation and aid in the recovery process of the tendon.
STRENGTHENING EXERCISES
• Heel raises – Performed in a single-leg standing position with bodyweight placed mainly in the forefoot region and heel
hanging off the low step. Lift heel off step, and then lower heel just past step height. Complete fifteen repetitions, three
times on each leg , resting for one minute in between sets.
You can use your arms for assistance, but ensure majority of your weight is going through your feet. It is advised this regime
be undertaken twice daily for twelve weeks.
• Inversion exercises – Turning foot inwards with an elastic Theraband (building up to three sets of thirty repetitions, twice daily)
PHYSICAL THERAPIES
• Massage – Massage of the tibialis posterior muscle/tendon region is appropriate as it improves blood circulation which
helps aid in the healing and regeneration process.
• Icing – Icing the tendon for five minutes on and then five minutes off after exercising will reduce inflammation too. Be
sure to move the ice pack around to avoid damage to the skin.
• Anti-pronation taping – This form of taping is designed to hold up your arch and re-align your foot into a neutral
position, thereby taking the unwanted pressure off the injured tendon. Tibialis Posterior tendon dysfunction has a positive prognosis if there is the appropriate rehabilitation program. Early
intervention is best, so if you suspect you are suffering from this injury, and have completed the above exercises with no
improvements, it is important to be seen by a health professional that can treat and manage you accurately.
Alice Goodear is a Podiatrist for Surfcoast Podiatry and works at the Belmont,
Ocean Grove and Jan Juc clinics.