Effect of eccentric exercise program for early tibialis posterior tendinopathy

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation

Background:

• Tibialis posterior (TP) tendinopathy is a common cause of foot and ankle pain.
• Understanding the changes in tendon morphology and vascularization is crucial for effective treatment.
• Functional status and pain levels are key indicators of treatment success in tendinopathy.

Purpose of the Study:

• To examine the morphological and vascular changes in tibialis posterior tendons post-intervention.
• To assess the impact of an eccentric loading program on functional status and pain in TP tendinopathy.
• To correlate imaging findings with clinical outcomes in patients with TP tendinopathy.

Main Methods:

• Ten subjects with early-stage TP tendinopathy underwent a 10-week eccentric tendon loading and stretching program.
• Grayscale and Doppler ultrasound were used to evaluate tendon morphology and neovascularization at baseline and post-intervention.
• Functional assessments included the Foot Functional Index (FFI), Physical Activity Scale (PAS), 5-Minute Walk Test, and single heel raise (SHR) test.

Main Results:

• Significant improvements were observed in FFI scores (total, pain, disability) from baseline to post-intervention and 6-month follow-up.
• The number of single heel raises increased significantly, indicating improved muscle strength and tendon capacity.
• Despite clinical improvements, tendon morphology and vascularization remained abnormal post-intervention.

Conclusions:

• A 10-week eccentric program effectively improves symptoms and function in tibialis posterior tendinopathy.
• Clinical improvements in TP tendinopathy can occur independently of changes in tendon morphology or vascularization.
• Eccentric exercise is a viable treatment option for early-stage TP tendinopathy, focusing on functional recovery.