This is one of the more common tendon disorders about the ankle.  It is usually caused by chronic inflammation, degenerative changes, and occasionally trauma, which leads to stretching, laxity, and eventual rupture of the tendon.

The posterior tibial tendon helps support the arch of the foot and provides power to point the foot down and to turn the foot inward.

Symptoms

Patients often experience tenderness and inflammation along the inner part of the ankle.  They note weakness when standing on their toes.

As the disease progresses, patients describe loss of the arch of the foot while standing.  Patients often note continued pain and inflammation.  The foot tends to turn outward with weight bearing.

Late stage disease includes a flat foot deformity with degenerative changes in the joints below the ankle.

Treatment

Initial treatment includes anti-inflammatory medications, rest, and ice.  Shoe inserts and wedges often provide relief of symptoms.  Occasionally, ankle-foot braces or casts are used.

If conservative measures fail, surgery may be considered.  Operative repair includes reconstruction of the tendon, osteotomies of the heel bone, and fusion of the joints below the ankle.