Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive medial arch pain and swelling in the right foot, exacerbated by weight-bearing activities. Reports a gradual loss of arch height and increasing difficulty with single-limb heel rise. No history of acute trauma. Pain is localized along the course of the posterior tibial tendon.
Clinical Examination Findings
Right foot examination reveals pes planus deformity with "too many toes" sign on clinical inspection. Tenderness noted along the posterior tibial tendon, distal to the medial malleolus. Single-limb heel rise test is weak or impossible on the right side. Passive range of motion of the subtalar joint is restricted; forefoot abduction is present. Neurovascular status is intact.
Treatment Protocol
Conservative management initiated including rest, ice, and non-steroidal anti-inflammatory drugs (NSAIDs). Prescription for custom orthotics or medial arch support provided. Physical therapy referral for strengthening of the posterior tibial tendon and intrinsic foot muscles. Immobilization with a walking boot or ankle-foot orthosis (AFO) considered if symptoms persist.