Posterior Tibial Tendonitis is also known as adult acquired flat foot deformity, is a severe injury. Hence, it can happen when the posterior tibial tendon tears because of overuse. The purpose of the tendon is to attach the muscle to the bone. It is the one that attaches the calf muscle to the foot. Also, it helps in supporting the structures of the foot and aids function while walking. It develops in only one foot, but some people may develop it on both feet.
1. It is an injury
An athlete of high-impact sports is at risk of this injury. Basketball and tennis are great examples of risky sports. This injury causes a foot deformity as it continues to progress as the arch of the foot can flatten. That results in the posterior tibial tendon not doing its job to support the arch of the foot. If caught soon enough, a post tib tendonitis will lessen the chance of having surgery as a treatment. Surgery is quite expensive and risky.
A study shows that the risk factors of post tib tendonitis are medical conditions. Diabetes, hypertension, obesity, and steroid use are the most common.
2. Three Stages
Johnson and Strom made a classification scheme in 1989. It is to describe the stages of posterior tibial dysfunction. It is the Johnson and Strom classification, named after them. Doctors use this to identify the stage of the injury and to know how bad it is.
Stage 1
In the first stage, the foot looks normal, but you may feel pain and swell along the tendon. The injury at this stage is the easiest to treat, and it does not involve complicated treatments.
Stage 2
As the condition progresses, when you try to stand, the foot appears flat. Meaning, the arch of the foot starts to collapse. It is still possible to correct the foot. The symptoms at this stage are still manageable, but foot deformity is now visible.
Stage 3
When you reach this stage, it is not possible to correct the foot deformity. At this stage, the tendons are very weak, and a single-heel rise is painful. Nonoperative methods in this stage may include walking cast and orthotics.
Stage 4
Upon reaching the most dangerous stage, it also requires invasive treatment. Once in stage 4, the foot is not the only one involved but including the areas near the ankle. There are still some treatments that are not surgical. Aside from surgical methods, there are some instruments used to accommodate the deformity.
3. Symptoms
Moreover, there is pain along the inside of the foot and ankle, where the tendon lies. The pain gets worse when you are moving. It can include having trouble walking or standing for a long time. Another is a swelling from the lower leg to the inside of the foot and ankle. If there is a visible change in the shape of your foot. You can ask someone to look at the back of your heel. Therefore, it is to check if the fourth and fifth toe is visible. If you see more toes, you have post tib tendonitis.
There is another method where you will do the single-limb heel-rise test. Start by standing on one leg and come up on tiptoes. If you cannot do this, you might have posterior tibial dysfunction.
4. Ways to prevent it:
Rest
The most common cause of the post tibial tendonitis is overuse. You can avoid this by resting. For athletes, it may not be a good idea to rest. But if you will not allow yourself to rest, your condition would not get better. It would get worse over time. Rest may not sound good for you, but it is the wisest thing to do if you want to save your foot. Hence, it may also include not using your foot in extreme activities requiring a huge amount of force. Avoid walking or standing for too long.
Braces
The braces would give support to the joints of the back of the foot. It also takes off the tension in the tendon. Using braces will save you from surgery. You can use braces to protect your ankle and foot from future injuries.
Physical therapy
Physical therapy helps strengthen the tendon. Likewise, it is one of the best options to take into consideration. It will save you from expensive and invasive surgery. For people who are afraid of operating rooms and a knife, this is the best option for you that still gives very promising results.
To avoid future complications, diagnose the injury early as much as possible.
