a 96% satisfaction rate for sore feet worldwide - express delivery

Posterior Tibial Tendon Dysfunction

by MASS4D® Prescription Orthotics April 05, 2017

Posterior Tibial Tendon Dysfunction

Posterior Tibial Tendon Dysfunction refers to either a sudden or progressive weakening of the posterior tibialis tendon, which is responsible for the dynamic stabilisation of the medial longitudinal arch.

In their study on the morphology and vascularisation of the tendon before and after a 12-week exercise programme, Kulig et al. state that the condition is characterised by fibroblastic hypercellularity and neovascularisation; the gradual collagen bundle degeneration and subsequent disarray impedes the optimal functioning of the posterior tibialis tendon.

A loss of strength of the posterior tibialis tendon is considered to be the most common cause of adult-acquired flatfoot, even though there are many other factors that could potentially contribute to a flatfoot deformity.

Besides acting as a key stabiliser of the medial longitudinal arch, the posterior tibialis tendon also helps in inversion and supination of the foot during gait, controlling pronation and facilitating weight distribution through the metatarsal heads.

Offer your Patients a Custom Calibrated Insole with a 98% Patient Satisfaction Rate     know more

While the exact aetiology of posterior tibial tendon dysfunction remains unclear, Bowring and Chockalingam categorise its suggested causes as: acute traumatic injury, inflammatory synovitis secondary to mechanical overuse or systemic disease and chronic tendon degeneration.

Factors which are considered to increase the risk of developing posterior tibial tendon dysfunction include the onset of inflammatory diseases such as rheumatoid arthritis, diabetes, smoking, ageing, obesity and menopause.

Management and treatment strategies for posterior tibial dysfunction can either be surgical or nonsurgical – an early diagnosis can prevent the need for surgical treatment.

Once a passive care programme has been implemented, rehabilitation of the posterior tibialis tendon in the form of eccentric strengthening exercises can help in preventing recurrence or progression of the condition in addition to stretching of the gastrocnemius and soleus muscles to prevent restriction of ankle dorsiflexion.

This needs to be enforced in conjunction with the use of customised foot orthotics such as MASS4D® to provide structural support to the feet, which would help in controlling severe pronatory forces often associated with posterior tibial dysfunction and in strengthening the weakened musculotendinous unit.

Copyright 2017 MASS4D® All rights reserved. 

Offer your Patients a Custom Calibrated Insole with a 98% Patient Satisfaction Rate     know more

Related Links


  1. Bodill, C., Concannon, M. (2012) Treatments for posterior tibial tendon dysfunction. Practice Nursing: August 2012, Vol. 23, No. 3, pp. 30-35
  2. Bowring, B., Chockalingam, N. (2010) Conservative treatment of tibialis posterior tendon dysfunction—A review. The Foot: March 2010, Vol. 20, pp. 18-26
  3. Kulig, K., Lederhaus, E. S., Reischl, S., Arya, S., Bashford, G. (2009) Effect of Eccentric Exercise Program for Early Tibialis Posterior Tendinopathy. Foot & Ankle International: September 2009, Vol. 30, No. 9, pp. 877-885

Also in Clinicians Blog

Pilates For Posture
Pilates for Posture Improvement

by MASS4D® Prescription Orthotics November 11, 2018

The emphasis of pilates on core strengthening and improvement of posture makes it a good addition to treatment and rehabilitative strategies, especially those that are designed to minimise postural disparities.

Read More

Posterior Ankle Impingement Syndrome
Posterior Ankle Impingement Syndrome

by MASS4D® Prescription Orthotics November 04, 2018

Repetitive plantarflexion can lead to pain and mechanical limitation in the posterior ankle joint which is known as posterior ankle impingement syndrome. This pathology commonly occurs in ballet dancers and football players. 

Read More

Os Peroneum Syndrome
Treating Os Peroneum Syndrome

by MASS4D® Prescription Orthotics October 29, 2018

Clinical diagnosis of os peroneum syndrome should involve physical examination that can help reveal swelling over the cuboid with pain felt during palpation. The patient will feel this pain intensify during plantar flexion, and during the heel elevation stage of the gait process.

Read More