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Tibialis Posterior Tendinitis

Tibialis Posterior Tendinitis is a painful condition that affects the tibialis posterior tendon, a key structure that supports the arch of the foot and helps with foot and ankle stability. When this tendon becomes inflamed or overused, it can lead to pain, swelling, and difficulty walking; especially on the inside of the ankle and foot.

This condition is also referred to as:

  • Posterior tibial tendon dysfunction (PTTD)
  • Posterior tibial tendinopathy

What Causes Tibialis Posterior Tendinitis?

This condition typically occurs due to:

  • Overuse, especially in runners or people who walk long distances
  • Flat feet or fallen arches
  • Improper footwear
  • Obesity, which places more stress on the tendon
  • Previous ankle injuries or trauma

Common Symptoms

  • Pain along the inside of the ankle and foot
  • Swelling in the lower leg or arch
  • Pain that worsens with activity, especially running or standing for long periods
  • Flattening of the arch (in more advanced cases)
  • Weakness or instability when walking

Podiatric Assessment of Tibialis Posterior Tendinitis

A detailed evaluation by a podiatrist is essential for accurate diagnosis and to prevent the condition from progressing into posterior tibial tendon dysfunction (PTTD), which can lead to permanent flatfoot deformity.

1. Medical History
  • Onset of pain and activities that worsen symptoms
  • Past foot or ankle injuries
  • Footwear habits
2. Physical Examination
  • Palpation of the tibialis posterior tendon for tenderness and swelling
  • Observation of foot posture (e.g., arch collapse or overpronation)
  • Single-leg heel raise test (difficulty indicates dysfunction)
  • Assessment of range of motion and muscle strength1. Medical History
3. Gait Analysis
  • Watching how you walk to detect overpronation (rolling in) or imbalance
4. Imaging
  • Ultrasound or MRI to assess tendon inflammation or degeneration
  • X-rays to rule out structural deformities or arthritis

Treatment Options for Tibialis Posterior Tendinitis

Early intervention is crucial to prevent long term damage. Treatment varies depending on the severity of the condition.

Non-Surgical Treatments
  • Rest & Activity Modification: Reducing or avoiding high-impact activities like running or long walking
  • Ice Therapy: To reduce inflammation and pain
  • Anti-Inflammatory Medications: NSAIDs may be used short-term
  • Supportive Footwear: Proper arch support can reduce strain on the tendon
  • Custom Orthotics: Specially made shoe inserts to support the arch and improve foot alignment
  • Ankle Bracing or Taping: To reduce movement and allow healing
  • Physical Therapy: Strengthening and stretching exercises for the tibialis posterior and surrounding muscles
  • Shockwave Therapy: To promote healing in chronic cases

When to See a Podiatrist

If you’re experiencing persistent medial ankle pain, foot arch pain, or difficulty walking without support, early diagnosis and treatment can prevent the condition from worsening. Ignoring symptoms can lead to tendon rupture or permanent foot deformity.

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