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Posterior Tibial Tendon Tear Treatment

The posterior tibial tendon is located at the back of the ankle connecting the calf muscles to the foot. A tear in this tendon will result in pain, difficulty walking and may cause the arch to lose support such that it falls, leading to a "flat foot." Treating a posterior tibial tendon tear requires dealing with the inflammation, providing adequate support for the foot and improving the flexibility of calf muscles.

  1. Inflammation

    • Most any injury will lead to inflammation, which is the body's way of bringing nutrients to the area to heal. But too much swelling creates further immobility and pain, and can result in circulation problems. Reducing the swelling first involves stopping activity and resting. If at all possible, ice the leg immediately after the injury and for 20 minutes every two hours for the first two days. Wrap the ankle and elevate it to help reduce the swelling. Taking ibuprofen will also help with swelling reduction.

    Support

    • When you are able to place weight on the ankle, make sure the ankle is wrapped to prevent swelling from returning and to give the ankle support to mitigate any re-injury. Also, wrap the arch of the foot to provide it with added support. You may want to use a shoe arch-support insert, especially if the injury is a result of a chronic or degenerative problem. People with diabetes, obesity and hypertension are at risk for degenerative issues. Always consult with a doctor to make sure your diagnosis is the correct one with the proper course of action.

    Treatment

    • If the tear is significant or a complete rupture, surgery may be required to stop the tear from becoming a chronic problem such as posterior tibial tendinitis. Surgery repairs the damaged tendon and reattaches it in a way to reduce pressure. Physical therapy will work to improve leg flexibility in the calf muscles and maintain a complete range of motion in the foot. This is accomplished through stretching the foot against a wall with the toes elevated touching the wall and the heel on the ground. A deeper stretch-and-strength move is on a step or curb where you drop the heel down while balancing on your toes. Through the course of physical therapy, continue to ice the ankle after a workout to keep swelling down.

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