Posterior Tibial Tendon Insufficiency: Causes & Treatment

December 17, 2021
By: GraMedica Team

There is a condition when the inner arch area of the foot, usually in a person over 50 years of age, becomes very painful. The arch is much lower than “normal.” Many forms of treatment will be given but they only slow the inevitable, aggressive foot reconstructive surgery.

What is posterior tibial tendon insufficiency?

This is a disease process to a section of the tendon from the posterior tibial muscle. It is always found below the inner ankle bone and above the bump from the main bone of the arch. The main action of this muscle-tendon unit is to support the inner arch and strengthen the joints within the inner column of foot bones. The tendon becomes diseased due to decades of over-stretching of the tendon. By 50 years of age, the average person has taken over 90 million steps. That’s why this problem shows up mid-age or in older adults. It is associated with “adult acquired flatfoot” because there is always a lowering of the inner arch of the foot. What’s missed is that there was always a lower-than-typical arch. There is an underlying cause to this tendon disease.

What causes posterior tibial tendon insufficiency?

There have been many theories but the leading cause is relatively simple. It has to do with the partial dislocation of the ankle bone on the heel bone. This condition is present at birth, never gets better, and only gets worse. There is a path of destruction that occurs with ankle bone instability. First the ligament between arch bone and the heel bone is over-stretched and weakens. The next structure to be over-stretched is the plantar fascia. The very strong and thick posterior tibial tendon is the last one to become diseased. That tendon is responsible for supporting the inner arch. Imagine what happens to any strong cable after it has been excessively stretched tens of millions of times.

Importance of hindfoot stabilization begins with HyProCure.

HyProCure® is a titanium stent that is placed in the natural space between the joint surfaces of the ankle and heel bones. It is the only treatment option that is proven to realign and stabilize the hindfoot while allowing a natural range of motion. Instantly, the excessive forces acting on posterior tibial tendon are decreased by an average of 51%*.

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