With the NCAA tournament well under way, players are most likely doing their best to avoid any type of injury.  An injury common in athletes refers to posterior tibial tendonitis; however, this injury can occur in nonathletes as well.  The posterior tibial tendon courses along the back of the leg then on the inside of the ankle to the arch of the foot.  It functions to support the arch of the foot.

Posterior tibial tendonitis can occur due to injury or overuse.  There are certain risk factors to the development of posterior tibial tendonitis including being overweight, diabetes, and flat feet.  When the tendon’s function is compromised the arch of the foot may drop placing even more pressure on the tendon which can lead to inflammation.

Symptoms of posterior tibial tendonitis include tenderness or pain on palpation of the course of the tendon.  There may also be pain on the inside of the foot and ankle in walking.  Standing on the tips of the toes may also elicit pain due to weakness.  These symptoms progress as the condition advances.   Treatment of the condition includes non-steroidal anti-inflammatory reactions, applying ice for about 20 minutes two times daily, and rest.  Increasing the arch support of the shoe or adding orthotics can also help control the condition. 

If untreated and with continued overuse, posterior tibial tendonitis can progress to posterior tibial tendon dysfunction (PTTD), causing a progressive flatfoot deformity.   In addition to the above symptoms this may lead to arthritis and a change in gait, or the way a person walks.  The change in gait may even lead to pain in other areas involved in mobilization such as the knees, hip, and back.   With this said, it is important once symptoms begin to seek medical attention and to follow physician instructions to avoid progression.

If you are suffering from posterior tibial tendonitis, please do not wait to see a podiatrist.  The physicians at Atlantic Foot and Ankle Associates take a conservative approach for all types of injuries.   Make an appointment at one of our four offices conveniently located in Palm Coast, Orange City, Daytona Beach, and Port Orange and get back to walking pain free!

By Dr. James Rust

Phil Mickelson has been treated for arthritis that surfaced just before the U.S. Open and left him in so much pain he couldn't walk. Arthritis is a problem that we treat at Atlantic Foot and Ankle Associates on a daily basis. Because the foot and ankle have 36 joints, the inflammation caused by arthritis can cause limitation, pain, swelling, and ultimately affects day-to-day life. We try to find not only the cause of the arthritis, but also give patient's solutions to get them back to their activity level, with conservative measures and straightforward treatment options.

Many causes of arthritis exist, but most commonly is day-to-day wear and tear. Arthritis is also caused by a sudden trauma or repetitive small trauma, and can be due to the shape of the foot which can cause jamming of the joints. Hereditary factors, bacterial and viral infections, and multisystem disorders can also cause a lead to arthritis. Also, arthritis in one joint can cause or worsen arthritis in another joint seen commonly in the foot with bunions, hammertoes, or even an arthritic ankle.

Arthritic conditions are initially diagnosed with symptomatology, x-ray findings, laboratory studies, and ruling out other common tendon and ligament issues in the foot. At Atlantic Foot and Ankle Associates we not only use these tests, but also our clinical experience to determine how to gear the proper treatment toward each patient. Treatments include padding and strapping of the foot, molded insoles, multiple anti-inflammatory medications both topical and oral, and in severe cases an injection. In some cases, surgical options may need to be entertained.

We Atlantic Foot and Ankle Associates are familiar with the management and treatment of arthritis of the foot and ankle. Often times, there is no permanent cure. However through palliative treatment, proper shoes and insoles, and careful working with other physicians, we can get you on your feet pain free. Don't be one of the 40 million people in America that suffers with this disease. Visit one of our four offices (Daytona Beach, Palm Coast, Port Orange, and Orange City) and let us help you with your arthritis today.

By Dr. Matthew Hentzel, DPM