Tibialis Posterior Tendinopathy
By Laurence Schubert APAM
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The
tibialis posterior is a muscle that
begins just below the back of your knee and runs along the inside your entire
shin. It continues down the inner aspect of the heel and attaches to a bone in
the arch of the foot.
This
muscle primarily works a stabiliser and assists in moving the foot/ankle down
and inwards towards the midline of the body. However, its main role is to the
support the arch of the foot. Tendinopathy
refers to any type of pathology (injury) that affects the tendon or tissues
surrounding it.
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What are the symptoms?
Pain
will proximate along the inside of the foot and ankle (where the tendon lies).
This pain will be felt when touching the area and will be exacerbated with
movement, associated swelling is also common. Any activity that requires going
up on the toes, hopping or running may be painful. As the tibialis posterior
supports the arch of the foot, you may notice your foot rolling in during
walking or running. As a result, a compressive pain on the outside of the ankle
may be present. If the condition reaches a severe level, activities such as
running or even walking will be very painful.
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What are the causes?
Generally,
a sudden increase or change of activity levels will increase the likelihood of
developing tendinopathy. For tibialis posterior tendinopathy, repetitive
activities such as walking is likely to be the culprit. Biomechanical deficiencies
such as poor foot posture when walking increase the strain being placed on the
tendon, leading to a disorganisation of collagen fibres within the tendon.
Having
muscle weakness or tightness, being overweight and insufficient recovery
periods are risk factors to developing this tendinopathy. As well as past
injuries that affect the biomechanics of your ankle, e.g. sprained ankle.
Runners and walkers are the most commonly affected by this condition.
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How can physiotherapy help?
A physiotherapist will assess and diagnose your condition. Your physio will then analyse any contributing factors that are modifiable. This may include altering activity levels (a period of rest may be required), improving strength of certain muscles and improving foot posture. Initial pain relief will be the goal during the early stages of treatment which can be achieved through soft tissue massage, heat, ultrasound, ice, joint mobilisation and stretching. Your physio will discuss the best treatment options available for your individual case. Part of the recovery will include a targeted rehabilitation program which will strengthen your tendon and allow the tendon to sustain greater loads. This will allow you to get back to activity, with a little pain as possible.
Please contact us or book online if you want to find out more about Tibialis Posterior Tendinopathy or any other concerns that you may have.