Tibialis posterior tendinitis is a common overuse injury affecting the tibialis posterior tendon, which runs along the inner aspect of the ankle and foot. It is often associated with repetitive activities, such as running or walking on uneven surfaces. The condition can cause significant pain, functional limitations, and gait abnormalities. Early diagnosis and appropriate evidence-based treatment are essential for optimal outcomes.
Diagnosing tibialis posterior tendinitis typically involves a comprehensive clinical assessment, which includes a detailed history and a physical examination. Key signs and symptoms include localised pain, swelling, tenderness along the course of the tendon, and functional impairments.
Rest and Activity Modification: Resting the affected foot and modifying activities that aggravate symptoms are essential components of conservative management. Reducing weight-bearing activities and avoiding high-impact exercises can help alleviate stress on the tibialis posterior tendon.
Physical Therapy: Physical therapy plays a vital role in the management of tibialis posterior tendinitis. A structured program may include stretching and strengthening exercises targeted at the lower leg muscles, foot intrinsic muscles, and ankle stabilisers. Eccentric exercises, such as heel raises, have shown promising results in improving tendon function and reducing pain.
Orthotics: The use of orthotics, such as arch supports or custom-made foot orthoses, can help offload the tibialis posterior tendon and provide mechanical support to the arch of the foot. These devices aim to improve foot alignment, redistribute forces, and reduce excessive pronation, which may contribute to tendon overload.
Tibialis posterior tendinitis is a common condition that can cause significant pain and functional limitations. Evidence-based treatment approaches, including rest, activity modification, physical therapy, orthotics, and, in some cases, pharmacological interventions, can effectively manage symptoms and promote recovery.