Posterior Tibial Tendonitis
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The Spring Ligament (Plantar Calcaneonavicular ligament) is positioned on the underside of the foot connecting the calcaneus bone to the navicular bone. The function of the Spring Ligament is to provide stability to the underside of the foot and the foot’s medial arch. Ligaments attach bone to bone, and alongside the Posterior Tibial Tendon, the Spring Ligament maintains the arch height of the foot.
The symptoms of a Spring Ligament injury include pain, bruising and swelling on the underside of the foot. Pain is worse when weight-bearing at it places the spring ligament under a stretch, while activities such as walking, running or jumping can further exacerbate pain levels.
As the Spring Ligament is instrumental to the stability of the arch of the foot, if it becomes torn, it can lead to a visible reduction in the medial arch height of the foot, causing a flat foot deformity.
Repetitive strain to the Spring Ligament from activities such as running can cause a Sping Ligament strain. In some instances, such as a fall from a height, there may be an acute tear or rupture of the Spring ligament.
Weakness to the Posterior Tibial Tendon can place extra stress on the Spring ligament leading to attenuation and stretching of the Spring Ligament, resulting in a slow progressive tear.
If you suspect that you have a Spring Ligament injury, we recommend that you have a consultation with a Physical Therapist or a Podiatrist. A physical examination can identify a spring ligament injury using the Neutral Heel lateral push test.
It is common for a clinician to refer for imaging to rule out other conditions associated with a Spring ligament injury, such as midfoot arthritis and Posterior Tibial Tendonitis. An MRI is the best scan to identify a Spring Ligament injury,
Physical Therapy is an effective form of treatment for a Spring Ligament injury. Assessing the strength, flexibility and mobility of the foot and ankle helps a therapist create a rehabilitation protocol for a Spring Ligament injury consisting of balance and strengthening exercises.
A custom insole can support the foot’s arch alongside a stability-cushioned trainer. Home management can include reducing your step count and overall time on your feet while applying ice to the affected area for pain relief and taking anti-inflammatories such as Ibuprofen to reduce inflammation in the ligament.
In severe cases, a patient may be advised to spend a period in a walker boot to help offload the foot. After removing the boot, 4-6 weeks of Physical Therapy are carried out to help return the patient to normal functional levels.
A Spring ligament takes 4-6 weeks to heal in mild cases, while in severe cases, it can take 3-6 months for a Spring Ligament to heal.
The spring ligament supports the medial longitudinal arch of the foot. Alongside the Posterior Tibial Tendon, the Spring Ligament plays a vital role in maintaining the structural integrity of the foot.
Yes, you can tear the spring ligament. The most common type of tear is a slow progressive tear that results from an adult-acquired flat foot, but it is possible to tear a Spring Ligament from running or landing from a fall.