Many patients come to me asking if I can help them with their posterior tibial tendon dysfunction, another name for this condition is posterior tibial tendinitis. There may be even a posterior tibial tendon tear. The fact is, that posterior tibial tendon problems occur with the flattening of the arch. This tendon wraps around from the lower leg to the inside of the arch, inserting onto the bones of the foot. Take a look at the first model. This view is looking at the foot from the side (the side closest to the other foot). The blue band represents the tibial tendon. Do you see how it wraps around the inner ankle and inserts on the bones near the arch? Posterior tibial tendon issues are secondary to the ligaments of the foot wearing out.  In the second model, we can see how many ligaments are holding the bones together in the foot. And even this complicated model does not show many more ligaments because every single bone attaches to the bone next to it, from the ligaments holding them together.

In Posterior Tibial Tendon issues, the underlying problem is the ligaments supporting the arch. As they wear out with aging, weight, injury, and shoes without arch supports,  at a very subtle level, the bones “sag”. The feet become flatter. The tibial tendon is responsible for holding those bones up. It becomes stretched sometimes to the point where it tears. Once again PRP and Dextrose prolotherapy to the rescue!!!. With a skilled practitioner of PRP and Dextrose Prolotherapy, we can strengthen all of the ligaments around the inside arch, the arch itself, as well as the subtalar joint (the joint underneath the ankle joint) which relieve the stress on the Posterior Tibial Tendon. Pain is much better now if not gone! If you or someone you know has pain on the inside of their ankle, it may be PTT trouble and we can help, (415) 506-4907