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Posterior Tibial Tendonitis, Orthotics
Objective: Posterior tibial tendinitis and dysfunction is a known cause of adult-onset flat foot and typically presents with a history of low arches. Orthotics are used to effectively treat stages I and II of the condition, while stages III and IV often require surgical intervention.
Clinical Features: A 49-year-old male had stage III posterior tibial tendonitis and dysfunction without low arches prior to collapse, with associated low back pain.
Intervention and Outcome: Patient was fitted for orthotics with a forefoot varus post and high arch support as well as soft tissue mobilization and rehabilitation to the surrounding musculature, laser therapy, dry needling, and spinal manipulative therapy to the low back.
Intervention and Outcome: After treatment, decreased pain and swelling were achieved in the affected foot. However, treatment is ongoing, and his condition is being monitored for progression.
Conclusion: Orthotics should be considered as a first line treatment and management of stage III and IV PTTD, with surgical intervention considered should the deformity progresses.
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