Tibialis posterior tendon and deltoid and spring ligament injuries in the elite athlete.

Isolated deltoid ligament injuries account for no more than 3% to 4% of all ankle ligament injuries.

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Acute isolated deltoid ligament injuries promptly diagnosed can usually be treated conservatively.

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Untreated acute tears of the spring ligament in the athlete can lead to progressive deformity similar to tibialis posterior dysfunction.

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There is little place for conservative treatment of complete acute spring ligament tears in the elite athlete; minor tears with no deformity may be considered for cast immobilization.

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For tibialis tendon problems, most insertional and early tendon abnormalities can be treated conservatively with attention to underlying biomechanical and technical deficits.

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Surgical interventions should only be considered after an adequate period of assessment and conservative treatment. In the absence of significant disability, simple synovectomy and decompression may suffice.