To tell if a posterior tibial tendon is torn, you should look for a combination of specific symptoms and perform a simple self-assessment. A torn posterior tibial tendon, often associated with posterior tibial tendon dysfunction (PTTD), can lead to pain, swelling, and a progressive flattening of the arch of the foot.
Key Symptoms to Watch For
Recognizing the symptoms early is crucial for effective management. A torn posterior tibial tendon typically presents with:
- Pain or tenderness on the inside of the shin, ankle, or foot. This pain often worsens with activity, such as walking, running, or standing for long periods.
- Swelling along the course of the tendon towards the foot, specifically on the inside of the ankle. This swelling may be visible and palpable.
- Inability to raise the heel and go on tiptoes. This is a significant indicator, as the posterior tibial tendon is essential for pushing off the ground and supporting the arch.
Self-Assessment: The Single Heel Raise Test
A simple yet effective way to assess the function of your posterior tibial tendon is the single heel raise test:
- Stand with your feet shoulder-width apart, holding onto a stable object for balance.
- Lift one foot off the ground.
- Attempt to rise onto the toes of the standing foot.
If you have a significant tear or dysfunction of the posterior tibial tendon, you will likely find it difficult or impossible to perform a single heel raise on the affected side. You may also notice your arch collapsing inward (pronating) as you attempt the movement.
Progression of a Torn Posterior Tibial Tendon
If left untreated, a torn posterior tibial tendon can lead to the progressive collapse of the foot's arch, resulting in what is commonly known as adult-acquired flatfoot. Over time, the foot may begin to turn outward, and the pain might shift to the outside of the ankle as other structures become strained.
When to Seek Medical Attention
While self-assessment can provide strong clues, a definitive diagnosis of a posterior tibial tendon tear requires evaluation by a healthcare professional, such as an orthopedic surgeon specializing in foot and ankle conditions. They will perform a thorough physical examination, assess your range of motion and strength, and may order imaging tests like X-rays or an MRI to confirm the diagnosis and determine the extent of the damage. Early diagnosis and treatment are vital to prevent further progression and potentially avoid more invasive interventions.
