Tibialis posterior tendinopathy

The refers to inflammation in the tibialis posterior tendon that runs behind the medial malleolus (the bony lump on the inside of the ankle). It is usually an overuse injury. The tibialis posterior is crucial in maintaining the arch of the foot, and tendonitis is closely linked with over pronation of the foot.

You will experience pain behind the medial malleolus. It usually starts gradually and may initially only be painful after exercise (often the following morning). As the condition gets worse the symptoms become more intrusive and may start to interfere with sport and cause pain with day to day activities. You may notice swelling in the tendon at the back of the malleolus. Sometimes a clicking sensation can be felt. Standing on tiptoes may be painful, or even impossible on the affected side.

If you think you have this condition it is well worth getting it checked out by Mr Willis-Owen. In the mean time you should avoid any aggravating activities which may prolong the problem. It generally won't get better on its own. Anti-inflammatories and ice are helpful after exercise.

Treatment involves first confirming the diagnosis then establishing the cause. An MRI scan or an ultrasound scan can be useful to exclude other problems and confirm the diagnosis. Treatment options may include specific physiotherapy, orthotics, and injections. Once you are recovered it is important to address any biomechanical problems, or other underlying factors in order to prevent recurrence.

Mr Willis-Owen suffered with this condition during marathon training, and successfully treated it with a change of running shoe and the use of orthotics along with some physio.