We report a case of chronic posterior tibialis tendinopathy related to instability of the first ray. A method for assessing first ray mobility is described. Options for treatment are discussed. For this patient, surgical arthrodesis of the first metatarsocuneiform joint and Achilles tendon lengthening eliminated instability of the first ray and improved the capacity of the medial longitudinal arch to carry weight, allowing the chronically inflamed tendon to heal, and the patient to return to full activity.
- First ray
- Posterior tibialis