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Posterior Tibial Tendonitis: A Concerning Source Of Heel Pain In Runners

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Are you a runner who has developed pain on the inside of the foot and ankle, along with flattening of your arch? Chances are, you're suffering from an injury known as posterior tibial tendonitis. This running injury may not be as common as runner's knee or plantar fasciitis, but it definitely deserves your attention because it can get a whole lot worse if left untreated. Read on to learn more about the causes of PTT, along with your treatment options and ways to prevent the injury from recurring in the future.

Causes of PTT

Like most running injuries, PTT is considered an overuse injury. It is most likely to occur when you suddenly add mileage or intensity to your training plan without giving your tendons and other tissues enough time to recover and adapt. Runners who pronate (have ankles that tilt towards the inside as they land) are more likely to develop PTT since their stride puts more stress on the posterior tibial tendon, which runs along the inside of the heel to about the middle of the side of the sole of the foot. The injury is, by definition, a swelling of this tendon.

The arch flattening that occurs as a result of PTT occurs because as this tendon swells and shortens, it pulls the soft tissues of the foot downward.

Treating PTT

It is very important to seek treatment for PTT rather than continuing to run through the pain. Left untreated, the condition can lead to permanent arthritis in the foot -- and that will surely affect the future of your running career. Your podiatrist will devise a personalized treatment protocol based on the severity of your PTT. This may include:

  • Wearing a specially made orthotic device in your shoes in order to reduce the strain on your posterior tibial tendon as you walk.
  • Performing exercises to stretch and strengthen the tendon and surrounding tissues.
  • Wearing a boot or cast for a few weeks in order to immobilize the foot and speed healing.
  • Performing surgery to repair advanced stages of PTT.

Preventing PTT

Once you are recovered, you will want to do all that you can to prevent PTT from recurring. Have your podiatrist analyze your stride and recommend orthotics to prevent pronation. Make sure you're running in shoes that fit your feet properly. (A technician at a local running store can help you choose the right pair.) Most importantly, stick to the 10% rule, increasing your running mileage by no more than 10% each week to prevent excess strain on your tendon. Read more here.