Pain and swelling along the inside of the ankle may be easy to dismiss as a minor strain. But when discomfort is accompanied by arch fatigue, flattening of the foot, or increasing difficulty walking, a problem involving the posterior tibial tendon may be responsible.
The posterior tibial tendon plays a major role in supporting the arch of the foot. When it becomes inflamed, stretched, or weakened, the arch may gradually collapse.
Bay Podiatry Associates in Brooklyn, NY evaluates posterior tibial tendon problems, adult-acquired flatfoot, and other causes of pain along the inside of the foot and ankle.
What Is the Posterior Tibial Tendon?
The posterior tibial tendon runs from the calf, behind the inside of the ankle, and attaches to bones in the foot.
Its main functions include:
- Supporting the arch
- Stabilizing the foot
- Assisting with walking
- Helping the foot push off the ground
What Is Posterior Tibial Tendon Dysfunction?
Posterior tibial tendon dysfunction, sometimes called progressive collapsing foot deformity, occurs when the tendon becomes damaged or weakened.
As the tendon loses its ability to support the arch, the foot may gradually flatten and turn outward.
What Does Posterior Tibial Tendon Pain Feel Like?
Symptoms may include:
- Pain along the inside of the ankle
- Arch pain
- Swelling
- Foot fatigue
- Difficulty standing on one foot
- Trouble rising onto the toes
- Progressive flattening of the arch
- Pain after walking
Later stages may cause discomfort on the outside of the ankle as the foot position changes.
What Causes Posterior Tibial Tendon Dysfunction?
Potential factors include:
- Repetitive overuse
- Tendon degeneration
- Injury
- Obesity
- Diabetes
- Hypertension
- Inflammatory conditions
- Aging-related tendon changes
Not every patient has an obvious triggering event.
Can Posterior Tibial Tendon Dysfunction Cause Flat Feet?
Yes.
It is a common cause of adult-acquired flatfoot.
As the tendon weakens, the arch may gradually collapse and the heel may drift outward.
How Can You Tell if One Arch Is Collapsing?
Possible signs include:
- One foot looking flatter than the other
- More toes visible from behind the affected foot
- Increasing shoe wear along one side
- Arch pain
- Ankle swelling
- Difficulty performing a single-leg heel rise
A podiatric examination can assess these changes more accurately.
Can This Condition Be Treated Without Surgery?
Many patients begin with conservative treatment, especially in earlier stages.
Options may include:
- Activity modification
- Supportive footwear
- Bracing
- Orthotics
- Immobilization in some cases
- Rehabilitation
- Anti-inflammatory measures when appropriate
Early treatment may help reduce stress on the tendon.
Can Orthotics Help Posterior Tibial Tendon Dysfunction?
Yes, in selected patients.
Orthotics or braces may help support the arch and reduce strain on the tendon.
The appropriate device depends on the severity of the condition.
Why Is Early Diagnosis Important?
The condition can be progressive.
In early stages, the foot may remain flexible. As the deformity advances, joints may become stiff or arthritic, making treatment more complex.
When Is Surgery Considered?
Surgery may be considered when:
- Significant pain persists
- The deformity progresses
- Conservative treatment is unsuccessful
- The foot becomes rigid
- Arthritis develops
The procedure depends on the stage and severity of the deformity.
When Should You See a Podiatrist?
Seek evaluation if you have persistent pain or swelling along the inside of the ankle, progressive flattening of the arch, or increasing difficulty walking.
Frequently Asked Questions About Posterior Tibial Tendon Dysfunction
Why does the inside of my ankle hurt?
Possible causes include posterior tibial tendon dysfunction, ankle injury, arthritis, or other tendon and ligament problems.
Can posterior tibial tendon dysfunction happen in only one foot?
Yes. It may affect one foot more than the other.
Can the arch collapse in adulthood?
Yes. Adult-acquired flatfoot can develop when supportive tendons and ligaments weaken.
Is posterior tibial tendon dysfunction painful?
It commonly causes pain and swelling along the inside of the ankle and arch.
Can I still walk with posterior tibial tendon dysfunction?
Many patients can walk, but symptoms may worsen as the condition progresses.
Can orthotics prevent the arch from collapsing further?
They may help support the foot and reduce strain in selected patients, particularly in earlier stages.
Can exercises strengthen the tendon?
Rehabilitation may be helpful in certain stages, but exercise should be guided by the diagnosis.
Does posterior tibial tendon dysfunction always need surgery?
No. Many patients are treated conservatively, especially when the condition is identified early.
When should arch collapse be evaluated?
New, progressive, or painful arch flattening should be evaluated by a podiatrist.
Contact Information
If you are experiencing pain along the inside of your ankle or noticing that your arch is becoming flatter, Bay Podiatry Associates can evaluate whether posterior tibial tendon dysfunction may be responsible.
Bay Podiatry Associates
8635 21 St Ave Suite 1C
Brooklyn, NY 11214
Phone: (718) 266-1986
Website: baypodiatrybrooklyn.com
Book Online: baypodiatrybrooklyn.com/appointments/