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About Common Midfoot Conditions and Injuries

Tendonitis

Pain and or swelling along the tendon, usually from irritation as a result of overuse. 

Cause:

Overwork or strain of any tendon-including sprains (partial tears). Certain medications and or tendon diseases-such as rheumatoid disease or contractures

Symptoms:

Pain and or swelling along the tendon with or without an area of hard swelling indicative of a tear. Pain with movement first thing in the morning with movement that may or may not improve with activity

Treatment:

Protect tendon.  RICE (rest, ice, compression, elevation) treatment for the first 2-3 days after injury-then you may apply heat for soreness. Oral anti-inflammatories such as Advil or Tylenol for two to three weeks.  Physical therapy. Biomechanical  analysis and/or computerized orthotics .Brace or surgery for unstable or badly sprained tendon- Early treatment prevents arthritis of the joint and tightness of the tendon


Posterior Tibial Tendonitis

Posterior tibial tendonitis causes pain along the inner side of the lower leg, ankle or foot.  Tendons are strong bands of connective tissue which attach muscles to bones.  The posterior tibial tendon helps point the foot down and in.  Tendonitis is inflammation of a tendon.

Cause:

Posterior tibial tendonitis occurs from overuse of the tendon.  This tendon attaches to a bone in the foot called the navicular and helps stabilize your arch.  If your arch flattens out more than normal when you walk or run it is called over-pronation.  When you over-pronate you strain your tendon and are more likely to get posterior tibial tendonitis.

Symptoms include:

  • Pain or tenderness on the inner side of the shin, ankle or foot
  • Pain with lifting up your foot
  • Pain walking or running

Treatment may include:

  • Applying ice packs to your foot for 10 minutes on, 10 minutes off and then 10 minutes on again every 3 to 4 hours for the first 2 to 3 days or until the pain goes away.  Thereafter, ice your foot at least once a day until the other symptoms are gone.
  • Doing ice massage.  Freeze water in a cup and then peel back the top of the cup.  Massage the ice into the painful tendon for 5 to 10 minutes.
  • Elevating your lower leg and foot by placing a pillow underneath it.  Try to keep your foot above the level of your heart.
  • Your provider may recommend special arch supports or inserts for your shoes called orthotics, either custom-made or off the shelf.
  • Taping your foot to give extra support to your arch, the navicular bone and the attachment of the posterior tibial tendon.
  • Sometimes a cast is needed for a few weeks until the pain and inflammation go away.
  • Using crutches until you can walk without pain.
  • Taking anti-inflammatory medication or other pain medication prescribed by your provider.
  • Doing exercises will help you return to your normal activity or sports.

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The definitions and treatments listed above are for informational purposes only and should not be considered diagnosis of your particular problem. 

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