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The position of the tendon is also thought to contribute, as it makes a sharp turn around the medial malleolus, putting a lot of tension on the tendon. Other proposed causes include constriction underneath the flexor retinaculum , talus abnormalities, osteoarthritis , and preexisting flatfoot . [ 2 ]
Posterior tibial tendonitis is a condition that predominantly affects runners and active individuals. It involves inflammation or tearing of the posterior tibial tendon, which connects the calf muscle to the bones on the inside of the foot. It plays a vital role in supporting the arch and assisting in foot movement.
In the case of posterior tibial tendon dysfunction causing flatfoot, sinus tarsi syndrome can also develop due to the disruption in the entire structure of the foot. [ 4 ] The condition is also thought to be caused by ankle/subtalar joint instability causing inflammation in the area.
If non-invasive treatment measures fail, tarsal tunnel release surgery may be recommended. Tarsal tunnel release is a form of a nerve decompression to relieve pressure on the tibial nerve. The incision is made behind the ankle bone and then down towards but not as far as the bottom of foot. The posterior tibial nerve is identified above the ankle.
The flexor hallucis longus is situated on the fibular side of the leg. It arises from the inferior two-thirds of the posterior surface of the body of the fibula, with the exception of 2.5 cm at its lowest part; from the lower part of the interosseous membrane; from an intermuscular septum between it and the peroneus muscles, laterally, and from the fascia covering the tibialis posterior, medially.
Posterior tibial artery. [2] Posterior tibial vein. [1] Tibial nerve. [2] Flexor hallucis longus tendon. [2] In the tunnel, the tibial nerve splits into three different paths. [3] The medial calcaneal branches of the tibial nerve continues to the heel, while the medial plantar nerve and the lateral plantar nerve continue on to the bottom of the ...
Enumerated from the medial side, the four canals which it forms transmit the tendons of the tibialis posterior and flexor digitorum longus muscles; the posterior tibial artery and tibial nerve, which run through a broad space beneath the ligament; and lastly, in a canal formed partly by the talus, the tendon of the flexor hallucis longus.
Posterior aspect of head and superior quarter of posterior surface of fibula; soleal line and middle third of medial border of tibia; and tendinous arch extending between the bony attachments Plantarflexes ankle independent of position of knee; steadies leg on foot