Physical Therapy for Posterior Tibial Tendonitis

The posterior tibial tendon runs along the lower portion of the shin, known as the tibia. Patients diagnosed with posterior tibial tendonitis can benefit greatly from a physical therapy treatment plan while under the supervision of a licensed therapist. Exercises and stretches focusing on maintaining range of motion (ROM) of the ankle and increasing strength within the affected limb are typically emphasized during treatment.

Initial Therapy

• Depending on the severity of the tendonitis as determined by a physician, initial therapy will focus mainly on stretches and limb movement to promote increased ROM within the affected leg. According to iTendonitis.com, posterior (meaning "back") tibial tendonitis is an uncomfortable condition that often results from a variety of physical activities that are either performed improperly or with excess, including swimming, running, or dancing. Since the inflamed tibial tendon runs behind the ankle, flexion and extension movement within the ankle may be minimal. Therapists will focus first on minimizing joint "freezing" around the ankle via small, controlled passive stretching. Patients will also often be required to wear a supportive brace or cast when not in therapy.

Mid Therapy

• As the patient continues to progress weeks into treatment, more weight-bearing exercises and more advanced stretching movements will be introduced. According to the University of Michigan Health System, exercises such as standing calf stretches, towel stretches, and various wobble board exercises will be implemented in the physical therapy treatment plan. The patient may be able to involve differing weight ranges via the use of dumbbells or ankle weights under the supervision of the therapist to help promote increased strengthening on the fine muscles surrounding the tendon.

Discharge and Home Therapy

• Near the end of treatment, the patient should regain complete use and ROM of the affected limb, including the ability to walk, run, and jump with minimal discomfort in the tibial tendon. At the time of discharge, patients will typically be prescribed a home exercise program to promote continued strength maintenance within the limb in the weeks following therapy. According to iTendonitis.com, posterior tibial tendonitis can have a relatively high reoccurrence, particularly if the patient partakes in highly active hobbies (such as sports) that require excessive use of the lower leg.