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Posterior Tibial Tendonitis

Tibialus Posterior muscle (Gray's Anatomy)
Also known as post-tib tendonitis, posterior tibial tendonitis affects the tibialis posterior. The tibialis posterior is the most central of all the leg muscles, and is located in the posterior compartment of the leg. It is the key stabilizing muscle and tendon of the lower leg.
Who it affects: 
People who overuse or misuse the muscles in their foot. Runners who have problems with overpronation are especially affected.
Symptoms: 

Symptoms can vary from aches or pains and local joint stiffness, to a burning that surrounds the whole joint around the inflamed tendon. In some cases, swelling occurs along with heat and redness, and there may be visible knots surrounding joint. With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiff the following day as muscles tighten from the movement of the tendon. Many patients report stressful situations in their life in correlation with the beginnings of pain which may contribute to the symptoms.

The tibialis posterior has a major role in supporting the medial arch of the foot. Dysfunction of the tibialis posterior, including rupture of the tibialis posterior tendon, can lead to flat feet in adults.

Treatment: 
Treatment of tendon injuries is largely conservative. Use of non-steroidal anti-inflammatory drugs (NSAIDs), rest, and gradual return to exercise is a common therapy. Resting assists in the prevention of further damage to the tendon. Ice, compression and elevation are also frequently recommended. Physical therapy, orthotics or braces may also be useful. Initial recovery is typically within 2 to 3 days and full recovery is within 4 to 6 weeks.