Tibialis Posterior Tendinopathy
Treatments Available At EKFC
What is Tibialis posterior tendinopathy?
Posterior tibial tendinopathy is a condition affecting the posterior tibial tendon, a key structure that supports the arch of your foot and helps control movement during walking. This tendon runs along the inside of the ankle and foot, connecting the calf muscles to the bones on the inner side of the foot. When overstressed or injured, the tendon can become inflamed, weakened, or degenerate over time—leading to pain, swelling, and difficulty with walking or standing. Patients often notice discomfort along the inside of the ankle or arch, especially during weight-bearing activities or after prolonged use.
Posterior tibial tendon dysfunction (PTTD) is a condition where there is an over use of the posterior tibial tendon and this usually presents with pain and swelling on the inside of the ankle. The posterior tibial tendon can over stretch and elongate when weight bearing causing micro trauma and swelling of the tendon, damaging the tendon structure. This causes ankle weakness and can cause a collapse of the arch and foot profile. PTTD is the main cause of the Adult Acquired Flat Foot Deformity.
Symptoms of PTTD
- Ankles rolling in.
- Pain around the inside of the ankle.
- Swelling around the inside of the ankle.
- Weakness in the ankle.
- Unable to complete a single leg tip toe.
- Pain on the outside of the ankle (sinus tarsi).
- Arthritis of the ankle.
If left untreated, posterior tibial tendinopathy can lead to progressive flattening of the arch and changes in foot shape, known as adult-acquired flatfoot. Common causes include overuse, poor foot mechanics, obesity, or inflammatory conditions such as arthritis. Early diagnosis is important to prevent long-term damage, and treatment may include rest, orthotics, rehabilitation exercises, footwear changes, or advanced therapies such as shockwave. With the right support, most patients can manage symptoms effectively and restore healthy tendon function.
Treatment Options for PTTD
During an initial consultation with your podiatrist, they will establish if you have PTTD and discuss the specific treatment programme for your condition. Treatment may consist of:
- NSAIDs
- Heat and ICE therapy
- MSK Analysis
- Orthoses
- Strapping
- Rehabilitation
- Footwear advice
- Shockwave therapy
- EMTT
- If the tendon is in a chronic stage of dysfunction then onward referral can also be useful which our team at East Kent Foot Care are able to initiate if required.