Tendonitis of the Foot (Posterior Tibial Tendonitis)

Tendinitis can affect four different tendons of the foot - the achilles tendon, the posterior tibial tendon, the anterior tibial tendon and the peroneal tendon. Posterior Tibial Tendonitis is a common overuse injury that affects the inside arch of the foot. This tendon that assists in holding the arch of the foot also prevents your foot from rolling. If a person has tendonitis of the foot, he or she may have inflammation at the in-step area of the foot and also have a flat foot deformity.

Symptoms of an inflamed posterior tibial tendon may include:
• Pain along the in-step of the foot.
• Shooting, stabbing or burning pain in the foot.
• If standing on their toes, the patient will feel intense pain in the arch of their foot.

Reducing the symptoms is the first step in alleviating this tendinitis, and your doctor will know how to do this best. Your doctor may tell you to use ice or heat, take certain medications, limit your activity to help control the pain and swelling, and self-massaging of the area. Ice helps prevent swelling and reduces pain. Place ice on the painful area for 10 minutes at a time, several times a day. If you already have swelling, heat may help. Apply a heating pad or hot towels to the tendon for 30 minutes at a time, two or three times a day. When treating the posterior tibial tendon, rest the area (meaning do NOT workout this area other than stretching), apply ice for 10-20 minutes at a time for at least 3 times a day. Do this to the injured area for the first day to 3 days. Moist heat may be used after the acute swelling is improved and rest prevents further muscle injury. Ice will reduces initial inflammation and swelling and the moist heat circulates blood through the area to speed the healing process. This can be further helped by the use of ultrasound applications over the affected area, as it reduces swelling quickly and increases blood flow to the area. If the patient gradually starting flexing and mobilising the area, the muscle would probably heal totally back to normal.

Returning to activity too soon will probably cause the symptoms to reoccur. Self-massage with heat inducing cream or oil may also help this. Physical therapists suggest rubbing the ointment in semicircles in all directions away from the knotted tissue three times a day until healed. Preventive measures for all types of foot tendinitis include, proper warm up and stretching exercises, wearing the right shoe for the activity, choosing shoes with good arch and heel support and varying your exercise route and routine. (This will help keep one set of muscles from being overstressed).

The trick to any tendon injury is getting it to heal with minimal scar tissue formation and with as much realignment of tendon fibres as possible - something radiant energy and ultrasound are great at! Even with optimum healing there is always less elasticity in a previously injured tendon. The trick is to make sure you heal this the best you can, that way your chance of reinjury down the road is much lower than average - which is well over 50%.