Treatment of posterior tibial tendonitis

    Auteur: Podiatre Montreal

    Tendinitis of the posterior tibialis is a condition generally of degenerative origin causing significant pain in the heel that must be treated. Indeed, tibial tendinopathy can worsen over time leading to more and more suffering that can become truly disabling. It is nevertheless possible to treat heel tendinitis with the care of specialized and competent professionals able to diagnose an injury to the posterior tibial tendon and to propose an adapted treatment.

    Symptoms of posterior tibial tendonitis

    Tendinitis of the posterior tibial tendon will initially manifest itself as internal pain in the ankle. This pain is first felt occasionally when walking, then will intensify and become more and more frequent as time goes by. The person suffering from this type of condition may feel a burning sensation or a feeling of tension. Other symptoms may also indicate tibial tendonitis, such as calf cramps, stiffness in the posterior tibial muscle or tingling in the ankle. Swelling and redness of the ankle may indicate an accumulation of fluid in the ankle, indicating posterior tibial tenosynovitis.

    If the anterior tibial tendon is affected, pain will also occur in this area, resulting in burning sensations on the foot and swelling. From a practical point of view, the pain will be more and more intense and frequent in the absence of treatment, the descent of stairs will be painful and overall the mobilization of the ankle will cause systematic suffering. These conditions are most often of degenerative origin, but can also be caused by excessive stress, injury, trauma or poor foot mechanics.

    Causes and complications of posterior tibial tendonitis

    There are many causes of posterior tibial tendinitis, although it is often degenerative in origin. In fact, significant stress on the ankle, such as the practice of an intensive sport with a lack of stretching and repeated movements, or poor positioning of the foot accompanied by poor mechanics such as hyperpronation, can lead to micro ruptures of the tendon and eventually the appearance of this type of pathology. Similarly, dehydration can be a determining factor in the development of this type of tendonitis. In addition, certain lifestyle factors can also have an influence on the occurrence of posterior tibial tendonitis, such as significant weight gain, overweight or overwork. People with unequal leg length are also susceptible to developing this type of condition.

    In addition to lifestyle issues, tendinopathy can also result from direct trauma, in which case the rupture of the posterior tibial tendon is to be feared with symptoms that are all the more significant, particularly with disabling pain. Other, much more benign factors can also be the cause of this type of tendonitis, such as wearing unsuitable or worn-out shoes, or even ageing. When the pathology sets in, the affected person will feel real discomfort in the plantar arch, may suffer from motor difficulties and develop inflammation in the ankle. All of these consequences indicate the need to begin treatment to cure this condition as quickly as possible in order to prevent it from worsening and leading to consequences that are more difficult to manage.

    Home treatment and healing

    There are many effective home treatments that are relatively effective in the early stages of the disease. The most obvious is obviously to place the ankle at mechanical rest to allow the tendon to recover, so reducing physical activity is essential. It is also possible to play on the temperature of the ankle to have an impact on the pain by warming it up, for example, or, on the contrary, by applying ice.

    Stretching the feet is also frequently recommended in case of physical activity to prepare the tendon beforehand. Wearing laced shoes is also strongly recommended to limit the risk of this condition appearing. If it begins to set in, it may be useful to use prefabricated insoles or plantar soles to provide real support for the plantar arch. Finally, if the ankle begins to swell, the use of anti-inflammatory medication may also be useful to reduce inflammation.

    Treatments and therapy at a Podiatrist

    If the above-mentioned symptoms appear and persist, it is strongly recommended that you consult a professional for a clinical examination or even an MRI. The purpose of these examinations will be to confirm the diagnosis, but also to refine it in order to establish the degree of the pathology and thus propose an appropriate treatment.
    In fact, depending on the severity of the disease, the professional may suggest foot orthotics to relieve and support the plantar arch. An ankle brace may also be suggested to relieve the ankle and prevent recurrence once the tendonitis has been treated. If the tendinopathy is more serious, the Podiatrist, who is the most appropriate professional for this type of pathology, can propose medication and pain killers to relieve the suffering related to the tendinitis and reduce the inflammation that may be linked to it.

    Another option is physical therapy with the prescription of physiotherapy exercises. In more severe cases, radial shock waves or cortisone injections may be offered. However, if the MRI reveals a tendon rupture, surgery may be necessary to repair the injured area. Complete immobilization may also be recommended, in which case the tendonitis can be treated with a cast that allows the ankle to rest completely. Whatever the preferred alternative, the most competent specialist to advise you is the Podiatrist, so do not hesitate to contact us as soon as the pain becomes too intense to practice regular sports activities.


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      Podiatre Montréal
      1826 Sherbrooke O,
      Montreal, QC H3H 1E4