Have you ever noticed pain at the inside of your ankle and arch of your foot after you stand for an hour or so, that continually worsens? Do you feel like your “arches have fallen” or see that you have “flat feet”? Do you feel like you just HAVE to get off your feet at the end of the day? If you answered yes to any of these questions, you may be suffering from “Posterior Tibial Tendonitis”.
What in the world is Posterior Tibial Tendonitis? Well, it is inflammation of the Posterior Tibial Tendon. Tendons connect muscle to bone so there is also a Posterior Tibialis Muscle to go along with the tendon (all one unit). The Posterior Tibialis Muscle belly is located directly behind the lower leg bone with the calf muscle lying over top of it. The Posterior Tibialis muscle turns into the Posterior Tibial Tendon which runs down the inside of the ankle, behind then under the ankle bone. The tendon then runs under the inside of the arch to the other side of the foot. The Posterior Tibialis Muscle and Tendon’s job is to assist the calf muscle in propelling your body forward when walking, running or jumping. It is also responsible for maintaining and supporting the arch of your foot when standing, walking and performing any sort of weight bearing activity.
So what does this Posterior Tibialis Muscle/Tendon have to do with pain at the inside of my ankle?
Well, since I mentioned that the Posterior Tibialis Muscle/Tendon is located on the inside of your ankle, foot and arch, this is what “IS” most often hurting when standing, walking, running or jumping.
So what cause the Posterior Tibialis Muscle/Tendon to be painful?
There are a number reasons why the Posterior Tibialis Muscle/Tendon become painful: Flat Feet are a major cause of Posterior Tibialis Tendonitis due to the fact that when your feet are flat, the arch drops to the floor and over-stretches the Posterior Tibialis Tendon causing it and it’s muscle to weaken and become inflamed to protect itself from being overstretched. The Posterior Tibialis can also become inflamed from beginning a new activity too aggressively too soon, for example: if while you are accustomed to walking 10 miles a week and suddenly you begin running 50 miles a week with no gradual progression, this could lead to pain at the inside of the ankle due to Posterior Tibial Tendon irritation.
So HOW do I get rid of this pain?
Generally you need to strengthen your calf and Posterior Tibialis Muscle (since it supports the arch and the inside of the ankle.) In addition you need to be fit with shoes specific to your foot-type. You may need to have custom orthotics made for you that go into your shoes and support the arch and the Posterior Tibialis tendon, thereby taking pressure off it and allowing it to heal. Another important step in getting rid of pain at the arch and inside of the ankle is attending Physical Therapy. Your Physical Therapist will determine what stretches and strengthening exercises you need to do and will utilize several techniques to calm down the irritation of the muscle/tendon.
AccessPT Physical Therapy specializes in treatment of the foot and ankle as well as the fabrication and fitting of custom foot orthotics. You are welcome to call my office (717-245-0400) and schedule a free screen with me so that I can help you figure out what is causing the pain, how to get rid of it and help you determine if custom foot orthotics are what you need.
Steve Miller PT, C.Ped is the owner of AccessPT Physical Therapy. If you have any questions you can contact Steve at: smiller@accessptw.com