Introduction
The tibialis posterior muscle muscle is one of the dynamic stabilizers active during the late midstance and push-off phases of gait. Therefore, tibialis posterior tendon dysfunction, also known as tibialis posterior tendinopathy, involves the progressive loss of this stabilization function. It tends to affect the athletic population, particularly runners and those involved in sports that require rapid changes in direction. Tibialis posterior tendon dysfunction (PTTD) has been described using a four-stage classification system ranging from mild signs and symptoms consistent with tendinopathy to a fixed hindfoot valgus deformity.
Symptoms of PTTD (not limited to)
- Pain and swelling along the inside of the ankle
- Pain along the posterior tibialis tendon that is aggravated with activity
- Flattening of the foot arch
- Difficulty standing on tiptoes
- Rolling inward of the ankle
Trigger Points in PTTD
Examination of the presence of trigger points is important with a potential diagnosis of tibialis posterior tendon dysfunction. There are several muscles whose trigger points refer pain to the medial ankle.
- Tibialis Posterior
- Tibialis Anterior
- Gastrocnemius
- Soleus
- Flexor Digitorum Longus
- Abductor Hallucis
- Gluteus Minimus
- Hamstring Group
How Chiropractic Care Can Help
Chiropractic care offers a holistic approach to treating PTTD, focusing on relieving pain, restoring function, and preventing future injuries. Here’s how we can help:
1. Comprehensive Assessment
Our first step in treating PTTD is a thorough assessment. We evaluate your foot mechanics, posture, and gait to understand the underlying causes of your condition. A thorough examination of the foot, ankle, knee, and hip should be performed as well as an evaluation of all lower extremity musculature.
2. Manual Adjustments
Chiropractic adjustments can realign the bones in your ankles, foot, knee, hip, and pelvis which helps reduce stress on the posterior tibialis tendon. By restoring proper alignment, we can help alleviate pain and improve function. Radiographs reveal a talonavicular subluxation is commonly present in PTTD.
3. Soft Tissue Therapy
Soft tissue therapy, including massage and myofascial release, can help reduce inflammation and improve blood flow to the affected area. This promotes healing and reduces scar tissue formation.
4. Customized Orthotics
We may recommend custom orthotics to support your arch and reduce strain on the posterior tibialis tendon. These specially designed inserts provide the necessary support to promote proper foot mechanics and alleviate pain.
5. Exercise and Rehabilitation
Strengthening and stretching exercises are essential components of PTTD treatment. We guide you through a personalized exercise program to strengthen the muscles supporting your foot, knee, and hips, enhancing stability and preventing future injuries.
6. Lifestyle and Footwear Advice
Proper footwear is crucial in managing PTTD. We provide expert advice on selecting shoes that offer adequate support and cushioning, helping to prevent exacerbation of your condition.
Ready to take the first step towards recovery? Contact us at FRWD Sports Therapy to schedule a comprehensive assessment and begin your personalized treatment plan for posterior tibialis tendon dysfunction. Call or book your first treatment session online!