The posterior tibial tendon is a cord that starts at the calf muscles, stretches behind the inside of the ankle and attaches to a bone in the middle of the foot named the navicular bone. The navicular bone plays an important role in forming the arch of the foot. The posterior tibial tendon helps to stabilize the navicular bone, which holds up the foot arch and provides support as you step off the toes when walking. If your posterior tibial tendon is torn, you will need shoes that support your arch.
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Posterior tibial tendon tears can result in: loss of the arch, or flat feet, pain and swelling on the inside of the ankle and rolling of the ankle or foot inwards, which is over pronation. They also can make you unable to stand on the toes, pain on the outer side of the ankle as the arch flattens, and tenderness over the midfoot.
Tears in the posterior tibial tendon can be due to overuse activities that involve the tendon such as walking, climbing the stairs and hiking, especially when a person is not used to doing much of that activity. Athletes are also prone to posterior tibial tendon tears from overuse because of excessive training. Having previous steroid injections is also a cause, as trauma from the needle could weaken the tendon. People who are overweight are at increased risk because their tendon will stretch, and navicular bone support is decreased. Trauma can also damage the posterior tibial tendon.
Walking shoes that are labeled “straight last” and “motion control” are the best walking shoes to wear if you have a posterior tibial tendon tear. Motion control shoes prevent the foot from rolling inward because they have thick, stable insoles. These shoes also feature arch support. A straight last shoe has a wider base that is symmetrical; this helps to avoid over-pronation of the foot.
Torn posterior tibial tendons require arch support. A well-constructed straight last or motion control walking shoe will help to stabilize the arch and prevent further damage. Orthopedic inserts placed inside the shoe that support the heel and arch can also be used.