Leg Swelling due to Posterior Tibial Tendon Dysfunction - an Overview

Introduction

A condition that causes foot and ankle pain is posterior tibial tendon dysfunction (PTTD). Insufficient or inflamed posterior tibial tendon are other names for it. The posterior tibial tendon joins the calf muscle and the bones inside the foot. The tendon's primary function is to support the inside of the foot's arch. The tendon cannot sustain the arch if it is damaged or degenerated. The injury may be excruciatingly painful and harm foot and ankle motions, such as walking and running. The most typical reason for adult-acquired flatfoot is PTTD.

What Causes Ankle or Foot Swelling?

• Too much fluid in the tissues causes ankle or foot swelling, known as pedal edema.

• Peripheral edema, an accumulation of fluid in these bodily parts, is another name for the foot, leg, and ankle swelling.

• In most cases, fluid accumulation is not painful unless it results from an injury.

• Gravity causes swelling to typically be more pronounced in the lower portions of the body.

• Swelling in the feet, legs, and ankles is particularly prevalent in elderly persons. In addition, one or both sides of the body may experience edema.

• The lower body might be impacted in one or more places.

• Even while ankle, leg, and foot swelling often do not represent a serious health danger, knowing when to visit a doctor is crucial.

Who Is Impacted by Posterior Tibial Tendon Dysfunction?

With time and aging, the tendon frequently degenerates or wears out. But it may also have an impact on those with illnesses like:

1. Women and persons over 40 are the groups who have PTTD the most commonly.

2. Overweight or obese.

3. Elevated blood pressure (hypertension).

4. Diabetes.

5. Tissue damage to the ankle or foot.

6. Joint problems.

7. Prior surgical procedure.

8. Using steroids.

9. A fall or excessive usage of the tendon might harm it.

10. People who engage in high-impact sports or activities, such as long-distance running, track, and football, may repeatedly utilize their tendon torn.

What Are the Signs and Symptoms of a Malfunction of the Posterior Tibial Tendon?

Among the symptoms of PTTD are:

1. There is swelling and pain in the ankle or inside of the foot. Activity, such as standing or walking, may make this discomfort worse.

2. Standing on one's toes causes pain.

3. Roll inward of the ankle.

4. It is difficult to walk over uneven surfaces.

5. It takes a lot of effort to climb up and down the steps.

6. A previous limp that is becoming worse.

7. Unusual or unequal shoe wear.

How Is Dysfunction of the Posterior Tibial Tendon Identified?

• The doctor will check the ankle and foot for swelling along the posterior tibial tendon.

• The foot will be moved from side to side while they measure the range of motion in the ankle.

• Early symptoms of PTTD include swelling, discomfort, pain, or weakness when moving the foot or ankle.

• The healthcare professional will check the foot from behind for any modifications to its structure or contour.

• The inner arch may be flat on the ground, and the heel may point outward.

• The front of the foot may also turn away from the body to balance the adjustments to the inner arch and heel.

• The doctor will also check for a "too many toes" indication from behind the foot. On the exterior of a typical foot, just the fifth toe (pinky toe) and all or a portion of the fourth toe (ring toe) are visible. There may be more toes visible in people with PTTD.

• The condition of the posterior tibial tendon can also be evaluated with a single-limb heel-rise test. Again, one will need a chair or a wall to support during this exam to maintain balance. The next step is to lift the good foot off the ground and attempt to move the injured foot onto its toes. One should be able to easily perform eight to ten heel lifts with a healthy tendon.

• It may not be feasible to complete even one heel raise in the early stages of PTTD.

What Is the Remedy for Posterior Tibial Tendon Dysfunction?

Depending on how severe the symptoms are, PTTD therapy may vary. However, many signs of tendon injury will disappear with nonsurgical therapy if it is detected in its early stages, including:

1. Rest: Abstain from actions that aggravate or exacerbate the discomfort. Without harming the tendon, low-impact activities can help maintain overall general health. These include swimming, elliptical exercise, yoga, and bicycling.

2. Ice: Apply an ice pack for up to 20 minutes, three or four times a day, to the most painful regions of the foot or ankle.

3. Medication: Non-steroidal anti-inflammatory medicines (NSAIDs), including Aspirin, Ibuprofen, and Naproxen, are available over-the-counter and can help with inflammation and discomfort. Speaking with a healthcare professional before using NSAIDs is a good idea because not everyone can take them.

4. Physical Treatment: Tendon-strengthening activities are part of physical therapy.

5. Orthotics: One may support the tendon and arch using over-the-counter shoe inserts or braces. The doctor could advise wearing a walking boot, a cast, or a specially-made orthotic brace that is fashioned to fit the foot.

6. Surgical Options: One can be sent to a foot and ankle surgeon if the pain does not get better or disappear entirely after at least six months of nonsurgical treatment. There are several surgical options depending on where the foot or ankle hurts. The severity of the tendon injury also affects the choice of treatment.

7. Massage: The tibialis posterior muscle, in particular, can benefit from deep tissue massage to relax the muscle and get rid of knots, lumps, and bumps. These are places on the muscle where it has tensed up, or muscles ached, making it impossible to function properly.

Conclusion

When posterior tibial tendonitis is severe, it is preferred to remain at rest. Healing will be aided by resting the feet. However, the tendon must fully heal to go back to normal activities. Instead, one may purchase custom orthotics to support and cushion while doing everyday activities. The first stages of PTTD (posterior tibial tendon dysfunction) can be treated with rest and over-the-counter or homemade medicines. The healing process for PTTD can take several months, and it is a severe ailment. Therefore, one might need to adjust how one does things every day. Reintroduce any workouts or activities one did before the injury gradually and gently.