Nonsurgical Management of Posterior Tibial Tendon Dysfunction With Orthoses and Resistive Exercise: A Randomized Controlled Trial

• Published in: Physical therapy 2009-01, Vol.89 (1), p.26-37
• Main Authors: Kulig, Kornelia, Reischl, Stephen F, Pomrantz, Amy B, Burnfield, Judith M, Mais-Requejo, Susan, Thordarson, David B, Smith, Ronald W
• Format: Article
• Language: English
• Subjects: Abnormalities; Adult; Aged; Care and treatment; Cohort Studies; Data analysis; Data collection; Exercise; Female; Foot diseases; Humans; Load; Male; Middle Aged; Muscle Stretching Exercises; Orthotic Devices; Pain - etiology; Pain - prevention & control; Pain Measurement; Physical examinations; Physical fitness; Physical therapy; Physiological aspects; Posterior Tibial Tendon Dysfunction - complications; Posterior Tibial Tendon Dysfunction - physiopathology; Posterior Tibial Tendon Dysfunction - therapy; Recovery of Function; Resistance Training; Studies; Tendon injuries; Tendons; Tensile strength; Tibia; Training; Treatment Outcome; Walking - physiology
• ISSN: 0031-9023; 1538-6724
• DOI: 10.2522/ptj.20070242

Tibialis posterior tendinopathy can lead to debilitating dysfunction. This study examined the effectiveness of orthoses and resistance exercise in the early management of tibialis posterior tendinopathy. Thirty-six adults with stage I or II tibialis posterior tendinopathy participated in this study. Participants were randomly assigned to 1 of 3 groups to complete a 12-week program of: (1) orthoses wear and stretching (O group); (2) orthoses wear, stretching, and concentric progressive resistive exercise (OC group); or (3) orthoses wear, stretching, and eccentric progressive resistive exercise (OE group). Pre-intervention and post-intervention data (Foot Functional Index, distance traveled in the 5-Minute Walk Test, and pain immediately after the 5-Minute Walk Test) were collected. Foot Functional Index scores (total, pain, and disability) decreased in all groups after the intervention. The OE group demonstrated the most improvement in each subcategory, and the O group demonstrated the least improvement. Pain immediately after the 5-Minute Walk Test was significantly reduced across all groups after the intervention. People with early stages of tibialis posterior tendinopathy benefited from a program of orthoses wear and stretching. Eccentric and concentric progressive resistive exercises further reduced pain and improved perceptions of function.