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Managing tibialis posterior tendinitis? Here's what an evidence-based approach suggests.



Tibialis posterior tendinitis is a condition where the tibialis posterior tendon becomes inflamed or damaged. An evidence-based approach to treating tibialis posterior tendinitis typically involves a combination of conservative measures to alleviate symptoms and, in some cases, surgical intervention. Here are some evidence-based strategies:


Rest and Activity Modification:

  • Evidence: Rest is often recommended to reduce stress on the inflamed tendon.

  • Rationale: Allowing the tendon to heal by avoiding activities that aggravate symptoms is crucial. Activity modification may include avoiding excessive walking or standing for prolonged periods.


Orthotic Devices:

  • Evidence: Orthotic devices, such as arch supports or custom orthotics, may help support the foot and reduce strain on the tibialis posterior tendon.

  • Rationale: Providing proper foot alignment and support can relieve stress on the tendon and improve symptoms.


Physical Therapy:

  • Evidence: Physical therapy with specific exercises targeting the tibialis posterior tendon has shown benefit.

  • Rationale: Strengthening exercises, stretching, and proprioceptive training can help improve muscle function, reduce inflammation, and enhance overall foot and ankle stability.


Bracing:

  • Evidence: Ankle-foot orthoses (AFOs) or braces can provide additional support to the affected foot and ankle.

  • Rationale: Bracing helps stabilise the foot and may alleviate symptoms by reducing excessive movement and strain on the tendon.


Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):

  • Evidence: NSAIDs may be used to manage pain and inflammation.

  • Rationale: By reducing inflammation, NSAIDs can help alleviate pain and discomfort associated with tibialis posterior tendinitis.


Corticosteroid Injections:

  • Evidence: Corticosteroid injections may be considered in some cases for short-term relief of inflammation.

  • Rationale: Injections can help reduce inflammation and pain, but their long-term use is generally avoided due to potential side effects and risk of tendon damage.


Weight Management:

  • Evidence: Maintaining a healthy weight can be beneficial in reducing stress on the tibialis posterior tendon.

  • Rationale: Excess body weight can contribute to increased strain on the tendon and exacerbate symptoms.


Surgical Intervention:

  • Evidence: Surgical intervention may be considered in cases where conservative measures fail to provide relief.

  • Rationale: Surgical options may include tendon repair, tendon transfer, or fusion procedures, depending on the severity of the condition.


It's important to note that the most effective treatment plan may vary from person to person, and a healthcare professional should evaluate and tailor the approach based on an individual's specific condition and needs.

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