Treating and Preventing Posterior Tibial Tendon Pain

Whether you run for fitness or simply walk a fair bit as part of your daily commute, you’re on your feet a lot in t he modern era. Yes, even if you’re one of those who are able to take advantage of the telecommute for work made possible by technology. We’re just much more active these days than ever before, partly because of the prohibitive nature of gas prices and partly because we’ve smartened up enough to see the value in living more mobile, more active lifestyles. However, this is also why an injury that sidelines how active we can be is a huge possible problem.

For instance, at some point in your travels you might notice some unusual pains in your foot that aren’t normally there. If you notice sharp pains in the foot, or in the arch of the foot specifically, usually accompanied by a stiff ankle or a swollen tendon area, you might have posterior tibial tendon dysfunction. This tends to also manifest as a popping sound made when you walk, and is usually accompanied by a degree of soreness to the touch. This is likely to get worse from here, possibly even lingering long and consistently enough to make walking and running extremely difficult because of the pain. As you can imagine, this makes a variety of physical activities almost impossible, so keeping the pain at bay and eventually keeping it from coming back is a sure objective.

What is it?

Posterior tibial tendon dysfunction is a common foot and ankle problem. As the name suggests, it is dysfunction in the form of inflammation or physical damage such as tearing that affects the posterior tibial tendon. This tendon attaches the calf muscle to the bones located on the inside of one’s foot. The posterior tibial tendon is generally expected to hold up the foot arch and provide support when walking. It’s particularly problematic if the ailment worsens such that the tendon becomes unable to support the arch of the foot, resulting in flatfoot. This condition is typically addressed through orthotics or braces, usually not requiring surgery.

Posterior tibial tendon dysfunction tends to be caused by an acute injury to the foot, such as might be sustained from a fall. However, it is similarly likely to occur from overuse, such as in walking or in playing particularly active sports such as soccer, tennis or basketball. The inflammation or tearing of the tibial tendon will cause the arch to fall as time passes. It’s worth noting that some risk factors include obesity, hypertension, diabetes, and age; the latter can be seen in how the dysfunction typically affects those above 40 years of age.

When seeking to deal with posterior tibial tendon dysfunction, the first thing to do is stop running through the pain. This will only aggravate the injury. There are some ways to rehabilitate the affected area. These are typically done in phases, so make sure to check with your physician about when you’re ready to move on to the next task. If any of these bring pain, stop immediately.

Exercises To Manage Your Pain:

1. Calf Exercise

Remember that the posterior tibial tendon is one that acts to stabilize the foot, like a huge steel cable that provides the tension necessary to support the suspension bridge formed by the arch of the foot. As such, problems affecting this tendon decrease the ability to provide and maintain this tension.

Most treatments for posterior tibial tendon dysfunction incorporate a calf stretching regimen. Stand in front of a wall with one foot forward and one back. Keep both feet flat on the ground and stretch the calf of the rear leg, and hold for 30 seconds. This can be done three times, with one set with knees straight snd another set with the knees bent. This can also be done with an incline board.

2. Theraband Exercises 

These exercises address the need for basic muscle endurance that becomes much more heightened with posterior tibial tendon dysfunction. They should be done with light resistance and always wearing proper shoes and orthotics, and the up and down motions should be done slowly. Inversion, eversion and dorsiflexion can be done once a day, and building up to 200 repeats can be done over time with a weak theraband. Note that all of the motion should come from the ankle; one should take care not to roll their leg. You can put a towel under your foot to help create a smoother motion as well.

3. Single Leg Heel Raise 

Standing on one leg, raise yourself up slowly, then lower yourself in a controlled manner. Do this for a few raises at a time, and keep building up until you can do 50 at a time.

4. Toe Walking 

As the name suggests, this mostly involves walking in a straight line with ankles plantar flexed, and with heels high above the floor. 8 to 10 yards is a good enough distance to start with, and you can work until you can do 100 yards.

Beyond these exercises that target the rehabilitation of the affected area, one can also relieve the pain by using the traditional methods. Icing the affected area is recommended as always, particularly after one of the rehabbing exercises. The cold will help soothe the pain felt in the nerves in the area, and help reduce the inflammation as well. Additionally, foam rolling the calf muscles is also known to be a good complement to the exercises.

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