Doctor: Posterior Tibial Tendonitis Is “Extremely Common with Rheumatoid”

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We interrupt our regularly scheduled program for a brief discussion of posterior tibial tendonitis in “Rheumatoid Arthritis” (RA) / Rheumatoid Disease (RD). There is a long list of topics I want to cover, but sometimes the RD itself pushes other things farther down the page. This week, I continued to have problems putting weight on my left foot for two reasons, the ankle, and some inflamed metatarsophalangeal (mtp) joints.

What is the posterior tibial tendon?

swollen-ankle-interruption-quote“You’re limping worse,” the trustworthy podiatrist noted.

“I forgot what you said it’s called, but it keeps coming back,” I said. He answered, “It’s the posterior tibial tendon.” (Until recently my ankles had previously swollen on the outside, so this is different.)

I’ve never given a nickname to my foot doctor, but I’ve been with the same podiatry practice almost nine years. It was his partner that first identified my RA diagnosis – from my feet. I’m thinking Dr. Dependable would suit him because he says things like “We’re here if you need us.” And they do work me in whenever the RD makes my feet desperate.

According to,“The tibialis posterior muscle is responsible for moving the foot and ankle towards the midline of the body and pointing the foot and ankle down (plantarflexion)…” That’s exactly what I couldn’t do whenever I showed my ankle to my doctor recently. (Click on that link to see a picture of how the foot won’t turn inward.) “Whenever the tibialis posterior muscle contracts or is stretched, tension is placed through the tibialis posterior tendon.”

Posterior tibial tendonitis: “It’s extremely common with rheumatoid.”

My ankle has been so painful it wakes me up at night. Then I can’t put any weight on it on the way to the bathroom. Some days it’s very puffy looking and other times there’s no visual satisfaction. Even then, trying to turn my foot inward is very painful. “I don’t know you don’t want to hear it again, but this is what happens in rheumatoid,” said Dr. Dependable.

“You’ve seen it a lot?”

“Yes of course.”

Standing on rocks (under the skin)

steroid-shots-left-footThe past few weeks, I couldn’t step on my left foot on a hard surface without soft shoes. Even with prednisone, the feeling of a rock under the skin wasn’t going down. Dr. D examined the two middle joints I complained about and noticed right away the Tailor’s bunion / bunionette was also bigger. He gave it a little squeeze, asking: “This hurts?”


“Okay,” he told his assistant, “bring me 3 small and one larger needle.”

That was two days ago, and it’s feeling much better now. I have my bony ankle back and barely notice any lump under my foot, although a bare foot on a hard floor is still uncomfortable. Doc recommended I also use a lace-up ankle brace when it gets inflamed, so we’ll see how that works.

What about you? Has your ankle ever swollen on this side? Do steroid injections in your joints help? Do you ever wear an ankle brace?  

Related stories

lace-up-ankle-braceA prominent rheumatologist wrote to me a few years ago about RA that “Some few are crushed by it, some succeed and are happy in spite of it… it is difficult to have a chronic illness, and for some people it is too much to handle.” I didn’t fully agree with him because physical symptoms are sometimes perceived as personal weakness. Apart from pain, most people experience a loss of function that can be hard to comprehend… Click to continue reading The Pursuit of Happyness When Part of Your Life Is Called Rheumatoid Arthritis.

How wonderful to hear a simple “God bless you” when your feet are bright red and can barely walk. A small act of sympathy is a reprieve from the dismissiveness so common to RD. Continue reading Red Feet, Frankenstorm, Unexpected Sympathy, and Travel to PCORI Workshop

Recommended reading

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Kelly Young. All rights reserved.

This entry was posted on Wednesday, October 22nd, 2014 at 2:13 pm and is filed under Treating RA. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.


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