Hi, and welcome to our next episode in Sports Podiatry. Today, we’ll be looking at a painful condition that runs through the middle of the ankle called tib-post tendinopathy.
Pain in the middle of the ankle is often caused by the tibialis posterior tendon, also known as the tib-post. The tib-post roll during walking is to prevent the arch from collapsing, and it’s often associated with what’s called tibialis posterior tendon dysfunction, which often comes along with a flat foot deformity. Today, we’re gonna be talking more about the actual tendinopathy, which is more of the painful condition rather than any actual structural deformity.
Tib-post tendinopathy is often characterized by a gradual onset of pain, although it can also be quite sudden for some patients as well. Tib-post tendinopathy is often characterized by a tenderness to touch, a swelling, there can be some redness or heat to the heat as well, although generally speaking, it’s quite a well-localized tenderness to touch. The painful condition is often worse in the morning in the first step or after a long day on your feet as well just due to the fact that the tendon can become quite overworked and needs to warm up with activity.
Tib-post tendinopathy is usually diagnosed in the clinical chair. It usually consists of a few clinical assessments, such as palpation, strength testing, range of motion testing, as well as a comprehensive visual gait analysis. Generally speaking, it is diagnosed in the clinical chair, although there are some tests which can help aid that diagnosis and sometimes that clinical decision-making pathway as well. These tests could include X-rays, ultrasounds and MRIs.
Tib-post tendinopathy is usually treated by off-loading the tendon. So, off-loading is basically the process of taking the stress and the strain off of the tendon. This can be completed with the use of strapping, footwear, orthotics, and braces. We also use physical therapy to help with the healing. So, physical therapy, usually includes massage and dry needling and we also do quite a little strength training and rehabilitation around tib-post tendinopathy as well. So, this is including strengthening of the muscle, stretching of the muscle, and even addressing issues with weakness in the flexibilities in surrounding tissues.
As tib-post tendinopathy is degenerative, it can present as a more chronic change called tib-post tendon dysfunction. ‘Cause tib-post tendon dysfunction is that chronic, arthritic change, which is associated with the tib-post tendon, it can become a poorer outcome in terms of your long term pain, so I guess the important thing is to treat early and diagnose effectively as well. The information provided today has been general; however, if you’d like a full assessment, please book in online at our website.