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The position of the tendon is also thought to contribute, as it makes a sharp turn around the medial malleolus, putting a lot of tension on the tendon. Other proposed causes include constriction underneath the flexor retinaculum, talus abnormalities, osteoarthritis, and preexisting flatfoot. [2]
Accessory navicular bone may cause a continuous stretch and stress on the tibialis posterior tendon which can progress to chronic disabling pain and may cause tendon rupture or secondary flat foot deformity; when this occurs this condition is commonly known as accessory navicular syndrome.
Treatment and the potential outcome of the treatment may depend on the cause. Anything that creates pressure in the tarsal tunnel can cause TTS. This would include benign tumors or cysts, bone spurs, inflammation of the tendon sheath, nerve ganglions, or swelling from a broken or sprained ankle.
Posterior tibial tendonitis is a condition that predominantly affects runners and active individuals. It involves inflammation or tearing of the posterior tibial tendon, which connects the calf muscle to the bones on the inside of the foot. It plays a vital role in supporting the arch and assisting in foot movement.
More rarely, excessive physical activity and other forms of foot trauma/chronic ankle injury are thought to be the cause. [1] [6] In the case of posterior tibial tendon dysfunction causing flatfoot, sinus tarsi syndrome can also develop due to the disruption in the entire structure of the foot. [4]
The flexor retinaculum of the foot extends from the medial malleolus above, to the calcaneus below. [1] This converts a series of bony grooves into canals for the passage of the tendons of the flexor muscles and the posterior tibial vessels and tibial nerve into the sole of the foot, known as the tarsal tunnel.
The flexor hallucis longus is situated on the fibular side of the leg. It arises from the inferior two-thirds of the posterior surface of the body of the fibula, with the exception of 2.5 cm at its lowest part; from the lower part of the interosseous membrane; from an intermuscular septum between it and the peroneus muscles, laterally, and from the fascia covering the tibialis posterior, medially.
Diagnosis is generally based on the symptoms, with medical imaging done to rule out other possible causes. [2] Shin splints are generally treated by rest followed by a gradual return to exercise over a period of weeks. [1] [2] [3] Other measures such as nonsteroidal anti-inflammatory drugs (NSAIDs), cold packs, physical therapy, and compression ...