The Center for Podiatric Care and Sports Medicine

My Posterior Tibial Tendon is Dysfunctional

Posted by on Thursday, April 12th, 2012


The great thing about the foot and ankle is that they are made out of so many parts, that you can learn about something new every day. For example, if someone had asked me this morning if I knew where the posterior tibial tendon is, I would have said, “The posti-what?” Now, though, I know where it is and know a little something about what it means for it to dysfunction.

Wait, you don’t? Well, let’s do something about that right now!

What and where is  the posterior tibial tendon? The posterior tibial tendon connects to the back of the shin bone, then runs down that bone, under the heel, to the bones on the inside part of the foot, near the arch. The tendon helps us walk and helps hold up the arch of the foot. It’s a pretty darn important tendon.

Sounds pretty solid. How does it dysfunction? The tendon can rupture from a sudden, traumatic injury, or it can tear from overuse. When that happens, the arch of the foot can fall, leading to flat feet, which is why the condition is sometimes known as “adult acquired flatfoot.” If left untreated, your foot will begin to roll inward; eventually arthritis may develop.

Who on earth could have that happen?! Athletes who do a lot of high impact activities, such as basketball players, tennis players, runners, or gymnasts, can injure their posterior tibial tendon because they are repeatedly pounding their feet. People with diabetes, obesity, or hypertension are more at risk than others for posterior tibial tendon dysfunction. Women are more likely to get it than men, and everyone over forty is more prone to it than those who are younger. Wearing completely flat shoes that offer no support too often can also contribute to posterior tibial tendon dysfunction.

How would I know if I have posterior tibial tendon dysfunction? Oh, you’ll know, because it hurts. You’ll feel pain on the inside of your foot (inside means the part that faces in towards your other leg). There may also be swelling in that area. Pain will get worse with activity, especially high impact activities. It might hurt enough that standing for a long time or walking will become difficult.

There may also be pain on the outside of the foot in the ankle area. This happens because if the arch of the foot collapses, the heel bone may shift out of position and push on the ankle bone.

If you have any of these symptoms, then it’s likely you have posterior tibial tendon dysfunction, or at least something very wrong with your foot. The best way to find out for sure is to see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) to get an accurate diagnosis.

What happens if I have posterior tibial tendon dysfunction? If it’s caught early enough, posterior tibial tendon dysfunction can be healed with simple steps such as rest, ice, anti-inflammatories, and possibly a cast or walking boot to immobilize the bones, though podiatrists will try to avoid that. Many people can be helped with orthotics for their shoes that will help build up the arch again; an ankle brace may be necessary for others. Some patients will benefit from physical therapy to help restore mobility.

If the posterior tibial tendon dysfunction is extremely bad, surgery may be required. Considering the severity of the injury, a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) will have several options–the tendon may just need to be cleaned out; the Achilles tendon can be lengthened to help add extra strength to the calf; the posterior tibial tendon can be replaced with a tendon from another part of the foot, typically the big toe or little toe (yes, tendons are recyclable!); bones can be cut or shifted, or fused together. Don’t worry, surgery is usually successful with few complications.

Posterior tibial tendon dysfunction is not a terribly common injury, but that doesn’t matter if it happens to you. If you suspect you have injured your posterior tibial tendon or think you have any other foot problem, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.