Mr Jason Hargrave

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Tibialis Posterior Tendon Dysfunction (torn tendon on inside of the ankle) and General Flatfoot Conditions

Tibialis Posterior Dysfunction Syndrome is a progessive condition which leads to a flatfoot deformity, with collapsing of the arch of the foot, weakness and chronic pain. This is usually a slowly progressive condition but can also happen quickly if the tendon ruptures suddenly. Swelling and pain along the inside of the ankle and foot with difficulty in being able to go on tip-toe on the affected side are characteristic.

In simple terms, small tears in the the tendon leads to stretching and weakness. During this process other structures in the arch, such as ligaments, also become weaker and stretch, and these will all need to be repaired and tightened as well as the tendon, when surgery is performed (see diagram below). In the early stages orthotics (insoles), physiotherapy and ankle braces may be helpful, but surgery is ususally necessary in the later stages.

Not all flatfoot is caused by this tendon problem and newer innovative treatments such as the hyprocure stent (sinus tarsi implant - www.gramedica.com) are simpler treatments with much shorter recoveries, which are yielding excellent results for flatfoot patients.