What you need to know about posterior tibial tendonitis

Sure, you’ve heard of Achilles tendonitis and plantar fasciitis, but what about posterior tibial tendonitis? Here’s what you need to know about this common, and quite painful, foot and ankle injury.

While posterior tibial tendonitis can be caused by acute trauma, such as a fall or a sprained ankle, it is often a result of overuse, particularly with activities on uneven ground like trail running and hiking.

Symptoms include pain just underneath the inner ankle bone or along the inside of the foot along the navicular bone, above the arch. Swelling may or may not be present. The pain often worsens with activity and usually the injured person has trouble standing tip-toe on the injured foot.

The posterior tibial muscle decelerates the foot at heel strike while running. When the tendon connecting that calf muscle to the bones on the inside of the foot becomes inflamed or torn, it may no longer be able to hold up the arch and support the foot during movement.

If this injury goes untreated, the arch of the foot can flatten and the toes begin to point outwards. Early treatment is key for posterior tibial tendonitis. If you wait too long to seek treatment, casting or surgery may be required. Early treatment consists of first resting and icing the tendon, then a slow progression of active range-of-motion, isometric strengthening and resistive strengthening exercises.

Proper orthotics can ease the pain and inflammation associated with posterior tibial tendonitis by preventing excessive pronation and providing a stable platform for the arch so the tendon can rest.