Medial Ankle

Question 1

List all the common pathologies affecting Medial ankle

Answer 1

Medial Malleolous Fracture
Flexor Hallucis Longus Tedinopathy
Post Tib Dysfunction
TarsalTunnel Syndrome
Deltoid Ligament Injury

Question 2

What is Post Tib Dysfunction and what is the main function of the Posterior Tibial Tendon

Answer 2

Degeneration of the Poseterior Tibial Tedon caused by repetetive loading/overuse

Function is its the Primary stabalizer of the Medial Longitudinal arch and the main invertor of the foot

Question 3

What condition is Post tib associated with

Answer 3

Adult acquired flat foot
Degeneration of the tendon affects the ability of the medial arch to raise causing the progressive flattening of the foot

Question 4

What are the charecterisitics of Post Tib Dysfunction

Answer 4

Pain and swelling medially excaserbated by activity
Standing on tip toes and walking up and down stairs may be painful
Medial arch collapse
Difficulty/inability to perform unilateral heel raise. Limited calcaneal inversion upon ascent

Question 5

How can Post tib function be diagnosed

Answer 5

Inversion resistance test
Too many toes sign
A single-leg heel raise: patients can’t do a single heel raise with the affected foot
Palpation along the tendon for pain

Question 6

What are the treatments for Post tib dysfunction

Answer 6

Activity modification - reduce activities that will stress the tendon particularly running jumping etc

Ice application - 10 min a day

Exercise programme:
Heel raise, Heel raise off a Step,
Banded stregthening - Place ankle over knee, place a resistance band over both feet, point toes and lift ankle upwards

Rearfoot Varus Post - Anti pronatory insole