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Posterior Tibial Dysfunction


The posterior tibial tendon runs down the calf, behind the inside of the ankle, and attaches to the middle of the foot. It helps maintain your arch and aids in walking. Inflammation of this tendon can lead to ankle pain and flatfoot. Tendon dysfunction is most common in women over 50 and often has no clear cause. Other risk factors include being overweight, diabetes, high blood pressure, previous surgery or steroid injections, previous injury, and inflammatory disorders.


  • Pain or swelling on the inside of the ankle
  • Loss of the arch
  • Inability to stand on tiptoe
  • Mid-foot pain during activity

Diagnosis is based primarily on your symptoms and a careful physical examination of your foot. One classic sign of posterior tibial tendon dysfunction is a tendency of the affected heel to rotate outward when standing on tiptoe. Your physician may also order X-rays or other imaging studies.

Treatment depends on how far the disorder has progressed. Conservative treatments include rest, anti-inflammatories, immobilization in a cast, and shoe inserts or orthotics. If the condition is more advanced or these therapies do not work, your physician may recommend surgery. There are a number of surgical treatments; the specific course of action will depend on your individual case.

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