Painful Progressive Flatfoot
West Vancouver Foot Clinic Will Diagnose and Relieve Your Foot Pain
Painful Progressive Flatfoot, otherwise known as Tibialis Posterior Tendonitis, occurs when the tendon of the tibialis posterior becomes inflamed, stretched or suffers a partial or total tear. If left untreated, this condition may lead to severe disability and chronic pain. Some people are predisposed to this condition if they have flat feet or an abnormal attachment of the tendon to the bones in the mid-foot.
The tibialis posterior muscle begins just below the back of the knee and runs along the back of the leg and the tendon then passes under the inner aspect of the ankle and attaches at the inside of the midfoot or arch area. The tendon is responsible for helping to maintain the arch in the foot while the muscle aids in lifting the heel off the ground when one walks.
When the tibialis posterior tendon is inflamed or partially torn, pain is felt from the inside of the ankle to the arch area. With a more severe injury, a swollen or bulbous area along the inside of the ankle may also be felt. If a sudden fall in the arch occurs, this may indicate a complete rupture of the tendon that will produce severe pain and requires immediate attention. The pain is usually worse while walking and especially while rising up on the toes. Walking up and down stairs may also be very painful. There is pain and tenderness with palpation along the course of the tibialis posterior tendon at the inside of the hind-foot and ankle area.
A complete history and physical examination must be performed. A radiograph or X-ray will be taken to evaluate any bony problems along the course of the tendon. An MRI may also be indicated to identify the extent and specific location of the damage of the tendon. An effective conservative treatment option for dysfunctional flatfoot in which the inner arch area is very painful when walking, is a fully correctional UCBL functional foot orthotic. This product is a custom made device. In severe cases, where the pain is debilitating and chronic, an excellent treatment modality is the Richie Brace.