Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive medial arch collapse of the left foot, associated with activity-related pain, fatigue, and localized tenderness along the posterior tibial tendon. Symptoms are exacerbated by prolonged weight-bearing and relieved by rest. No history of acute trauma.
Clinical Examination Findings
Left foot examination reveals loss of the medial longitudinal arch in weight-bearing position. "Too many toes" sign positive. Hindfoot valgus deformity noted. Posterior tibial tendon palpation elicits tenderness. Single-limb heel rise test is weak/impaired on the left side. Neurovascular status intact.
Treatment Protocol
Initiate conservative management with custom orthotic inserts for arch support. Prescribe physical therapy focusing on posterior tibial tendon strengthening and gastrocnemius stretching. Recommend supportive footwear with motion control. Consider NSAIDs for pain management as needed.