Posterior Tibial Dysfunction

By | June 10, 2022

Posterior tibialis dysfunction is a condition that affects the tendons in the posterior tibialis muscle. The corresponding tendons are located in the area of ​​the foot and lower leg. In posterior tibial dysfunction, the tendon becomes progressively damaged over time, leading to a progressive decline in function. Ultimately, the affected patients suffer from a so-called flat foot, since the planovalgus is deformed.

What is posterior tibial dysfunction?

Posterior tibial dysfunction is a progressive disease that affects a specific tendon on a muscle of the lower leg and foot. This is the so-called posterior tibialis muscle. The disease develops lesions on the tendon, gradually reducing the ability of the area to function. For hypertrophic cardiomyopathy dictionary definitions, please visit

In the majority of cases, the tibialis posterior dysfunction progresses to such an extent that the affected patients eventually develop flat feet. This is primarily formed by a deformed planovalgus.


Medical research is not yet fully agreed on the exact causes of the development of tibialis posterior dysfunction. The exact causes and factors in the pathogenesis of posterior tibial dysfunction have not been sufficiently researched. However, numerous research studies are working to elucidate the causative factors for posterior tibial dysfunction.

It is already known that the underlying damage to the tendon in the area of ​​the posterior tibialis muscle is primarily caused by degenerative processes. In addition, epidemic analyzes of the cases of the disease indicate that the disease occurs up to three times more often in female than in male patients.

Because posterior tibial dysfunction is a degenerative disease, certain lifestyle factors in the affected individual are conducive to disease progression. These include, for example, high blood pressure and obesity. Both features have already been identified by physicians as risk factors for the development of posterior tibial dysfunction.

Symptoms, Ailments & Signs

The tibialis posterior dysfunction is essentially characterized by certain signs of illness and symptoms. The main symptom of posterior tibial dysfunction is progressive damage to the tendon at a specific muscle between the foot and lower thigh. Posterior tibial dysfunction is degenerative in nature, so the lesion worsens over time.

In the advanced stage of tibialis posterior dysfunction, the affected person suffers from a deformed planovalgus, which results in a typical flat foot. This is comparatively easy to recognize by its characteristic appearance and leads to incorrect loading of the foot.

Diagnosis & course of disease

If patients suspect tibialis posterior dysfunction in themselves, they consult their general practitioner as a first step. This usually makes a referral to a specialized orthopedist. The doctor treating you inquires about the individual symptoms of the person concerned as part of the anamnesis.

The focus is on possible supporting factors, such as the patient’s lifestyle. The doctor fathoms the beginning of the symptoms and puts them in connection with the further living conditions of the sick person. After the patient consultation has provided the first significant indications of the tibialis posterior dysfunction, various clinical examinations follow.

In this way, the posterior tibial dysfunction is diagnosed step by step. Imaging examination methods are of great relevance. As part of an X- ray examination, the doctor recognizes the extent and severity of the deformation. In addition, magnetic resonance imaging is used to depict the underlying damage to the tendon even more precisely.

The treating specialist often also uses sonographic techniques for the examination. He also uses methods to check the existing muscle strength in the affected area. The disorder in the function of mobility and performance of the foot is also clinically tested.

Posterior tibial dysfunction is a disease that progresses through different stages. For this reason, it is part of the diagnosis to identify the appropriate stage of the posterior tibial dysfunction in the individual case. The gait pattern is sometimes used in the assignment to a disease stage of the tibialis posterior dysfunction.


Primarily, posterior tibial dysfunction results in permanent damage to the tendon of the foot, leaving the sufferer with flat feet if left untreated. Self-healing does not occur with this complaint, so that those affected are dependent on treatment in any case. The symptoms favor severe movement restrictions and thus also restrictions in the everyday life of the person concerned.

It may no longer be possible to practice a certain profession. Child development is also significantly delayed due to the tibialis posterior dysfunction, so that there can also be limitations in adulthood. Gait disorders can cause adolescents and children in particular to become victims of teasing and bullying. Many of those affected often suffer from mental health problems or depression.

In most cases, the treatment of tibialis posterior dysfunction takes place without complications. Physiotherapy and relief of the foot significantly reduce and alleviate the symptoms. In serious cases, surgical interventions may also be necessary to remove the dead tissue. The life expectancy of the affected person is not negatively affected by tibialis posterior dysfunction. If the treatment is successful, the development of the child will not be restricted.

When should you go to the doctor?

In the case of tibialis posterior dysfunction, treatment by a doctor must always be carried out. Without treatment, this can lead to serious complications or other complaints that can have a very negative effect on the quality of life of the person concerned. The earlier the disease is detected, the better the further course of this disease is usually. The doctor should be contacted if there are problems with the tendons on the foot.

In most cases, this leads to severe pain, which can also occur in the form of stress pain or pain at rest. Symptoms usually worsen if treatment is not started. A flat foot can also indicate tibialis posterior dysfunction and should be checked by a doctor. It is not uncommon for those affected to also suffer from a limp. As a rule, tibialis posterior dysfunction can be recognized and treated by an orthopedist.

Treatment & Therapy

Both conservative and surgical procedures are available for the treatment of tibialis posterior dysfunction. The first choice is usually the conservative treatment approach. Patients are advised to take particular care of the foot affected by the tibialis posterior dysfunction. The foot should only be loaded if the corresponding movements are not associated with pain.

In addition, people suffering from tibialis posterior dysfunction usually receive physical therapy. In addition, the patients wear shoe inserts to promote the longitudinal arch of the foot. The surgical procedures depend primarily on the stage of the tibialis posterior dysfunction. In the first stage, only a skin incision is usually used, in which inflamed tissue areas are removed.

Dead tissue on the tendon is also surgically removed. In the second stage, the tendon is transferred if possible. The damaged tendons are reconstructed with healthy ones. In the third stage, so-called osteotomies may be used.


Prevention of tibialis posterior dysfunction is possible by largely avoiding the previously known risk factors of the disease. These include, for example, excessive body weight and hypertension. Nevertheless, it cannot be ruled out that a tibialis posterior dysfunction also develops in the course of life in people without such favorable factors.


The aftercare of a tibialis posterior dysfunction depends on the severity of the disease, as well as the type and success of the treatment. If the disease has been successfully treated with physiotherapy and shoe inserts, moderate sport should be practiced over the long term, which on the one hand does not put excessive strain on the foot, but on the other hand supports the tendons and muscles in the lower leg and foot area. Which sport is the best can vary from person to person and depends on the resilience of the foot.

As a rule, running and Nordic walking are ideally suited, but jogging and competitive sports are not. If inflamed and/or dead tissue has been surgically removed, physiotherapy should first follow so that the tendons and muscles can regenerate. This should also be followed by permanent moderate sport. If bones had to be severed or a joint stiffened, the follow-up care depends on the remaining joint function.

The joint should also be loaded moderately here. However, it is often not possible to exert more stress than everyday stress. However, long-term physiotherapy can be helpful in maintaining the remaining joint function. If permanent pain in the joint remains, additional permanent pain therapy can be helpful. In the case of severe, persistent pain, long-term medication with opioids must be given. In addition, existing obesity should be reduced in all cases, and existing high blood pressure should be treated with medication.

You can do that yourself

A tibialis posterior dysfunction usually leads to symptoms in the patient, which increasingly impairs the quality of life, especially in advanced disease. For this reason, many sufferers want ways to alleviate symptoms and positively influence the course of the disease.

This includes patients with posterior tibial dysfunction having regular check-ups with their doctor, usually an orthopedist, and having the condition of the disease assessed. Medically prescribed insoles for the shoe are to be worn as prescribed. In addition, physiotherapy can be useful to partially counteract the progression of the posterior tibial dysfunction. The exercises learned during physiotherapy should also be used at home in your own interest in order to train the muscles and tendons and to positively influence the deformity.

In the case of severe pain, medicinal painkillers are recommended in order to alleviate the acute symptoms in the short term and to prevent the development of chronic pain. Patients with posterior tibial dysfunction are encouraged to think about their professional future and, if necessary, to seek retraining. This is because occupations in which people have to stand or walk a lot tend to be disadvantageous for the course of the disease. Special health shoes that are individually tailored and adapted to the patient’s foot are also extremely important.

Posterior Tibial Dysfunction