What is Posterior Tibial Tendonitis
When You Roll Your Ankle and the Pain is on the Outside of the Foot, You Have Most Likely Strained the Peroneal Tendons
You might be suffering from a Posterior Tibial Tendon Injury if you have:
- Pain on the inside of your foot (medial) centered around the in-step area.
- Inflammation on the inside of your foot (medial) centered around the in-step area.
- Decreased Arch Height, as this tendon assists in holding the arch of the foot upward.
- Weakness when rotating your foot inward (inversion) as this tendon prevents your foot from rolling.
- Foot Instability.
- Increased Arch Height.
Tendinitis of the Foot
Tendinitis can affect four different tendons of the foot - the achilles tendon, posterior tibial tendon, the anterior tibial tendon and the peroneal tendon.
If a person has tendonitis of the foot, he or she may have inflammation at the in-step area of the foot and also have a flat foot deformity. The inflammation can be caused by irritation and tiny tears in the posterior tibial tendon over time (referred to as chronic tendonitis) or due to an immediate traumatic strain or tear (referred to as acute tendonitis).
Symptoms of an inflamed posterior tibial tendon may include:
- Pain along the in-step of the foot.
- Shooting, stabbing or burning pain in the foot.
- If standing on their toes, the patient will feel intense pain in the arch of their foot.
A Posterior Tibial tendon injury is usually caused by repetitive use of the tendons, but can also be caused by trauma such as a rolled or sprained ankle. Little tears in the tendon irritate the tendon fibers resulting in pain and inflammation, resulting in an inability to maintain strength along the tendon.
Posterior Tibial tenosynovitis is swelling and inflammation of the tendons' sheath (or covering) which prevents the tendons from gliding smoothly within the sheaths, causing pain. It can be experienced at the same time of posterior tibial tendonitis, and has similar symptoms. It often results in trouble moving the ankle and will feel sore to the touch. In rare cases, tenosynovitis can be caused by infection, so it is always recommended to check with your doctor to rule this out as a cause.
Tearing of the tendon is not uncommon. This leads to pain, swelling, sensitivity and a sense of instability in the ankle. The tendon(s) can also pop out of the supporting ligaments that hold them in place; this is known as a tendon dislocation.
Who is at Risk?
- People who play sports or do activates that involve repetitive ankle movements.
- People who participate in activities such as running on uneven surfaces, racket sports, basketball, hiking, or skiing.
- People who wear ill-fitting shoes or shoes that cause foot instability, as these shoes will increase the risk of an inward rolled ankle
- People in aging populations, because our tendons lose elasticity and become brittle.
Treatment - What You Can Do!
Overuse or injury (direct trauma, a fall, an accident or rolling over on your ankle) will cause weakness and loss of range of motion in the ankle, and the tendons become irritated and inflamed. A posterior tibial tendon strain is kind of like taffy that has been overstretched until it becomes thin and eventually frays.
The tendon tries to protect itself from this constant irritation by trying to repair the damaged tissue. During the healing process your body will automatically fill in tears in your tendons with dense, brittle tissue called "scar tissue". The human body will use scar tissue as a temporary healing solution and will try to build the scar tissue as fast as possible to heal tears in your peroneal tendons. Scar tissue can form fast to strengthen the damaged tendon, but working fast doesn't mean that the job's done right. When scar tissue forms it doesn't come together as neatly as regular (healthy) tendon tissue would. Scar tissue fibers will lay down over top of your tear in a cluttered, messy and jumbled up way.
Imagine throwing a bunch of drinking straws in the air... When those straws hit the ground they will land in a random, unorganized way. It even seems silly to think that those straws could land perfectly straight and all in the same direction.
This is how scar tissue works. The scar tissue that forms in your strained ankle tendons will be unorganized and won't line up properly with the healthy tissue surrounding the tear. This scar tissue will also attach to everything in and around your ankle including the surrounding healthy tissue as well. This can result in a long-term fusing together of your tendon with everything around it; this will definitely freeze up your ankle, severely reducing your mobility.
What You Need to Successfully Treat Your Tibial Tendinitis Injury:
- A Professional Cold Compression Ankle/Top-Foot ColdCure Wrap® to reduce inflammation of the soft tissue injury (as soon as possible).
- A Deep Tissue Therapeutic Ankle/Top-Foot BFST Wrap® to increase Blood-flow to the injured tendons (
Blood Flow Stimulation Therapy™ Therapy).
These 2 tools are what you need for rapid healing. These are the tools that top professional athletes use to treat their injuries every day. And just like these athletes, you can treat yourself at home. In fact, if you want to heal properly you have to treat yourself because you need to treat your injury every single day.
At the AidYourTendon Online Store you will find the tools necessary to relieve the pain of foot tendon and ligament inflammation and dramatically speed the healing. A sesamoid tendon injury is a race against time. The faster and stronger you heal your tendinitis, the less chance there is for re-injury. As well, leaving tendonitis untreated could easily lead to the development of over-compensation injuries that can become surprisingly debilitating, leading to increased downtime and immobility.
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If you have a Tibial Tendon Injury, it's important to heal it quickly and completely. If you don't, it may plague you on and off again for years and cause more debilitating injuries due to over-compensation.
How Do I Diagnose Posterior Tibial Tendonitis
The diagnosis of posterior tibial tendonitis is usually made by examination of the ankle. A physical check by your doctor will help to determine where the tendons are inflamed, ruptured, or degenerated. The doctor will move your ankle into different positions during a physical examination. These tendons are usually checked by using the single foot raise.
Single Foot Raise
The patient is asked to stand with full weight on the afflicted foot with the other foot in the air. At this point the patient is asked to raise up on their toes. If the tendon is attenuated or ruptured, the patient will be unable to do so. In cases of tendonitis or tendinosis, the patient may be able to do so but it will be painful.
X-rays may be ordered to make sure there is no fracture or other problem with your fibula or the other bones in your ankle. Your doctor may order a magnetic resonance imaging (MRI) scan of your ankle. These images can show if there is abnormal swelling or scar tissue in the tendons. MRI scans can also show lengthwise tears in the tendons.
What Causes Posterior Tibial Tendonitis
Peroneal tendonitis is the degeneration of the tendon tissue in the ankle. What causes our tendon to start to fall apart?
- Poor footwear encouraging your foot to roll inward stretching the tendons.
- Improper training to an exercise program you have just started
- Repetitive ankle motions in sports, such as running and jumping
- A blow to the inside of the ankle or an ankle sprain
- A flat foot puts extra tension on the posterior tibial tendons. Chronic flat foot syndrome may mean your posterior tibial tendons have lengthened permanently.
- Incorrect alignment of heel and foot bones
- A build up of scar tissue on the tendon, the weakened area of the tendon may tear or lead to rupture
Posterior Tibial Tendon Dislocation (subluxation) / Tearing or dislocation can happen in 1 or both of these tendons. This leads to pain, swelling, sensitivity and a sense of instability behind the outside of the ankle. They can also pop out of the supporting ligaments that hold them in place (a dislocation). After this happens you might repeatedly dislocate the tendons in your ankle and this tissue will tear even more without proper treatment. If you suffer from torn (ruptured) or dislocated peroneal tendons you might need stitches or even a tendon replacement to fix the problem.
Nonsurgical Treatment for Posterior Tibial Tendonitis
If you have a lot of pain you may need to have a walking boot or cast for 2 to 4 weeks. If there is no pain or tenderness with walking a stirrup ankle brace, arch support, or lateral heel wedge can help to take tension off of your injured tendons.
In most cases, your Doctor will start with nonsurgical treatments options. Some of the options your doctor may recommend include drugs or medications like NSAIDs (non-steroidal anti-inflammatory drugs) to manage pain and inflammation. Your physician may also recommend specific footwear or refer you to a podiatrist. Alternative medications like cortisone injections are NOT advised for any type of tendon condition. This is because there is increased risk of rupture of the tendon following a cortisone injection.
Be Careful About Cortisone
Steroid injections can provide temporary relief from the pain of tendon related injuries and are very popular. However, these injections should generally be avoided if possible as they weaken the tendon and may lead to a rupture. If you do opt for an injection, doctors usually recommend that you do not participate in strenuous activities for several weeks to reduce the risk of a rupture.
"In other words, in some way, the cortisone shots impede full recovery, and compared with those adopting a wait-and-see policy, those getting the shots 'are worse off'. Those people receiving multiple injections may be at particularly high risk for continuing damage. (reference: Reynolds, G. (1288). Phys Ed: Do Cortisone Shots Actually Make Things Worse?. Well. Retrieved 17 November 2016, from website)
Doctors won't give you a cortisone shot if it's at all possible that you have a fracture (acute or chronic) in your sesamoid bone(s). If cortisone is used with even the slightest stress fracturing, the cortisone will make the injury worse by stopping the bone's natural healing process. Over time if left untreated, your fracture will get worse and surgery will be more likely needed.
"Complications of cortisone shots can include:
"Risks - Cortisone Shots - Mayo Clinic". 2016. Mayoclinic.Org. Accessed November 17 2016. website
- Joint Infection
- Nerve Damage
- Thinning of skin & soft tissue around injection site
- Temporary Flare of Pain & Inflammation in the Joint
- Tendon Weakening or Rupture
- Thinning of Nearby Bone
- Death of Nearby Bone
- Temporary Increase in Blood Sugar"
Treating Posterior Tibial Tendonitis - What You Can Do!
The good news is that most posterior tibial tendinitis injuries will heal with conservative treatments and surgery is often not needed! But what's better for posterior tibial tendonitis - heat or cold?
Get Swelling & Pain Down with the
Ankle/Top-Foot ColdCure Wrap®
RICE (Rest, Ice, Compression, Elevation) has been recommended for years by doctors, trainers, and other medical professionals to treat the pain and swelling, chronic pain from injury and after any re-injury. Overuse injuries need rest and time for the tissue to heal.
Although RICE can help to treat these symptoms, ice and freezer gel packs reach temperatures so low they can cause cryoburn, an ice burn on your skin. The problem is, up until now there hasn't been any other option to treat painful conditions and injuries, so ice and blue gel packs (full of anti-freeze and chemicals) have been the only choice up until now.
Fortunately you no longer have to settle for these ice cold methods that are uncomfortably cold against your skin, provide short term relief, cause ice burns, numb your skin and underlying tissue beyond feeling so you don't even notice the ice burn until it's too late and pool around your injury putting the cold everywhere except for where you need it most.
The Ankle/Top-Foot ColdCure Wrap® allows you to treat your ankle in an effective and convenient way. Our Freezie Wrap® will wrap around your ankle keeping the cold right over your posterior tibial tendons for the entire length of your treatment. Our food-grade, non-toxic gel packs can be chilled in the fridge or freezer to tailor the amount of cold that you need for your injury. It doesn't matter how you cool it down, because our gel packs are chock full of gel that's designed to cool down into millions of tiny snowflakes. This method of cooling means our gel packs aren't icy-cold and stay flexible even right out of the freezer! The cushioned gel will wrap around your ankle and it won't budge for the entire treatment period. You'll no longer have to deal with annoying pooling around your ankle or have to hold a hard block of ice on your injury!
Cold Compression Therapy with an Ankle/Top-Foot ColdCure Wrap® works by stopping and slowing nerve and cell function in the area and reducing swelling that can block blood vessels.
This is important because once blood vessels are blocked or damaged, they can no longer carry oxygenated blood through the tissue and tissue cells begin to break-down. Without cold compression therapy cellular break-down and tissue damage continues as the cells don't get the oxygen they need to survive. By limiting the amount of damage done to your tendon, you also limit the amount of healing that needs to occur. This is a very important step to heal tendon injuries faster and with less pain! This is why you need to treat your posterior tibial tendinosis/tendonitis right after it's hurt, when you notice pain / swelling / inflammation, or directly after a re-injury. Applying an Ankle/Top-Foot ColdCure Wrap® right away will stop the damage immediately and unblock your blood vessels to let your body's natural blood flow in to start healing the tissue.
Accelerate Tendon Healing with the
Ankle / Top-Foot BFST Wrap®
After the inflammation in your ankle has been reduced, providing extra blood flow and strengthening the tissue in your posterior tibial tendons and the surrounding area is recommended.
Using Blood Flow Stimulation Therapy™ (BFST®), will help with your recovery and heal your tendon more completely. BFST® increases the amount of blood that flows naturally to your soft tissue to nourish your tendons, improving elasticity and speeding the healing process. This increased Blood Flow Stimulation Therapy to your peroneal tendon(s) is greatly needed.
The only way to get Blood Flow Stimulation Therapy™ is through use of an Ankle / Top-Foot BFST Wrap®. The BFST Wrap® is the only treatment method that improves blood flow and circulation on a deep tissue level. Other methods of warming / heating tissue (hot water bottles, hot baths, etc) will only ever increase blood flow on a surface / skin level. These methods need a LOT of time to even reach your tibial tendons on a deep tissue level. And even if you were to use them this long your skin would heat up to an uncomfortable level and may even burn you.
The best source of heat treatment is from a product where you don't even feel that much heat. When you don't feel the heat, it means the therapy is working in your deep soft tissue which is really where you need it. It's kind of like how your heart works in your body. You can't "feel" your heart pumping blood all around your body to your arms and legs. You can't even hear your own heartbeat without listening very closely. This is exactly how deep tissue BFST® works too! You're not supposed to "feel" a lot of heat because the heat isn't treating your skin, it's treating your peroneal tendon increasing the blood flow right in your tendon tissue.
The Ankle / Top-Foot BFST Wrap® is the only product available anywhere that offers BFST® AND a thin, flexible Energy Web® (heating element) that conforms around your ankle. This Energy Web® also provides consistent, uniform heat all around your ankle to increase blood flow in the entire joint.
Our Ankle / Top-Foot BFST Wrap® is made from medical-grade material - this should be as important to you as it is to us! Other products that are sold in stores are considered "consumer goods" meaning the material only needs to be as good as a sweater that you wear. Clothing articles like this don't need to meet high standards of production or materials and may include materials that irritate your skin.
Since our wraps are medical-grade products registered with the FDA, they are of a higher quality and need to meet way more standards for manufacturing (ISO 10993 - bio-compatibility testing). This makes our wraps the safest product for heating treatment. Our manufacturer has spent years perfecting the wrap design to make sure you get the treatment you deserve!
Scar Tissue - A Big Problem with Tibial Tendinosis & Tenosynovitis
As we mentioned before, the body's natural way to repair tendon tears is to grow massive amounts of scar tissue. This is tough, dense, brittle tissue that isn't nearly as flexible as healthy tendon tissue. It's only meant as a band-aid solution to bring the edges of your tear together and prevent further damage to your tissue. Unfortunately scar tissue will grow in any direction and won't grow straight / flat like normal healthy tissue. This unorganized growth of scar tissue is ultimately what causes stiffening in your ankle, nerve entrapment, restriction of movement, less elasticity, poor circulation, and reduced flexibility of ankle tissue.
Scar tissue may plague you for weeks, months and maybe even years depending on your level of activity and the amount of conservative treatments you have done during your rehabilitation. Scar tissue is a major problem, especially when it comes to re-injury of your ankle. When dealing with scar tissue it's always important to:
- listen well to your physician and if conservative treatments are recommended, remember to stick to your (daily) treatment plan using these therapies
- frequent use of the Ankle/Top-Foot ColdCure Wrap® will help reduce the swelling very quickly. Much of the pain you feel will be from the swelling, and you will be surprised how fast the pain drops off once the swelling is down.
- the Ankle / Top-Foot BFST Wrap® is a safe, electromagnetic energy device that will help reduce scar tissue and increase blood flow to the area (thereby accelerating the body's own healing process).
- when applied before stretching, the Ankle / Top-Foot BFST Wrap® will help flush the area with fresh blood. This will help improve your range of motion and prevent re-injury.
Prevention and Promotion of Lifelong Health
If you want to avoid tendon re-injury, manage pain and strengthen the ability of your body to heal itself, an Ankle/Top-Foot ColdCure Wrap® and an Ankle/Top-Foot BFST Wrap® will provide exceptional results.
Why spend time in pain, off from work and missing out on an active lifestyle when you don't have to?
Learn More About SUPERIOR Posterior Tibial Tendonitis Treatments
Learn more about how the Ankle/Top-Foot ColdCure Wrap® is designed to be the most effective cold compression wrap on the market today.
Learn more about how the Ankle/Top-Foot BFST Wrap® helps with the healing process.
Preventive measures for all types of foot tendinitis include, proper warm up and stretching exercises, wearing the right shoe for the activity, choosing shoes with good arch and heel support and varying your exercise route and routine. (This will help keep one set of muscles from being overstressed).