musculoskeletal and connective tissue disorders
Tibialis Posterior Tendinosis and Tibialis Posterior Tenosynovitis
Introduction
Tibialis posterior tendinosis, which is degeneration of the tibialis posterior tendon, and tibialis posterior tenosynovitis are the most common causes of pain behind the medial malleolus. The posterior tibial tendon lies immediately behind the medial malleolus. Degeneration results from long-standing biomechanical problems, such as excessive pronation (often in people with obesity), hindfoot valgus or chronic tenosynovitis. A rearfoot tarsal coalition can create a rigid pes planus deformity and limit the function of the posterior tibialis tendon. Tenosynovitis of the tendon sheath begins with acute inflammation. The tendon can be involved by primary inflammatory disorders, such as Rheumatoid Arthritis (RA) or (See also Overview of Foot and Ankle Disorders .) 