Monday, 20 April 2015

Treatment and Rehabilitation for Post-Tib Tendonitis

Posterior tibial tendonitis is a condition where the posterior tibial tendon is put under strain, becomes torn or inflamed.  As a result, the tendon may not provide support and stability for the arch of the foot, thus causing a flat foot.

The most common cause of post-tib tendonitis is the overuse of the tendon. Some common symptoms of this condition include a nagging pain along the inside of the ankle, foot, or on the outside of the ankle, or pain that worsens with high-impact/high-intensity activities.

Treating Post-Tib Tendonitis

The best way to take care of post-tib tendonitis is to control the activity of your feet. Adequate rest helps the tissues of the feet to heal. Once they heal, you can get back to your daily routine. Some of the most common treatment options for this condition are as follows:-

Non-surgical Treatment

With appropriate non-surgical treatment, symptoms in most cases are relieved quickly. However, the pain may last for over 3 months even with treatment during the early stages. Patients suffering from pain for a long time may have to beat it for as long as 6 months after treatment begins.

  • Adequate rest: The first step is to stop all those physical activities that can increase the pain. Doctors may even recommend switching to low-impact exercises like swimming or walking.
  • Ice packs: Applying ice packs on the affected area is another effective way to decrease pain. You can apply cold packs for 20 minutes at a time for 3 to 4 times a day for getting relief. However, you should never apply ice directly on the skin.
  • Medications: Taking some anti-inflammatory, non-steroidal medicines about 30 minutes before you begin exercising can help limit inflammation in and around the tendons.
  • Physical therapy: This is another method that strengthens the tendons and helps patients suffering from mild to moderate levels of posterior tibial tendonitis.
Depending on your condition, you doctor may even suggest the use of orthotics and braces or cortisone injections.

Besides these non-surgical treatments, there are some surgical methods to deal with post-tib tendonitis. Surgery should be considered only if the pain or inflammation of the tendon does not subside after 6 months of treatment. 

Some of the common surgical methods used are:-
  • Tendon transfer
  • Gastrocnemius Recession (surgical lengthening of the calf muscles)
  • Osteotomy (cutting and shifting of bones to create a “normal” arch), and
  • Tenosynovectomy (resection or excision of a tendon sheath)


With some easy rehabilitation exercises, you can get relief from the pain and return to normal activities soon. Some exercises worth considering are:-

  • Towel Stretch: You need to sit on a hard surface and stretch your injured leg at front. Place a towel around your foot’s ball and then pull it towards your body, keeping the knee in a straight position. You have to hold this pose for at least 15 to 20 seconds. Doing this exercise 3 times a day would help.
  • Heel Raises: You have to balance your body on your toes as you stand behind a chair. You need to hold this pose for at least 5 seconds, after which you can come down to the earlier position. You can start with a set of 10 a day and slowly increase it to 3 sets of 10 reps a day.

    A few other exercises that can provide relief from post-tib tendonitis are the “Standing Calf Stretch”, “Resisted Inversion”, “Balance Exercises” (both dynamic and static) etc.

    Consult your foot doctor today to get the condition assessed and start treatment on time. Remember, with the right treatment and rehabilitation exercises, you will be able to control the swelling and pain and return to your favorite activities soon, albeit with some limitations. 

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