Posterior tibial tendonitis is one of the most common problems affecting the foot or ankle. The condition develops when a specific tendon in the leg is torn or inflamed, which causes pain and other symptoms. Also known as posterior tibial tendon dysfunction, posterior tibial tendonitis can develop as the result of an injury. Some people are more prone to developing the condition. An accurate diagnosis and treatment can help alleviate posterior tibial tendonitis.

Tendons attach your muscles to your bones. The posterior tibial tendon connects the bones on the inside of your foot to the muscle of your calf, which means it is one of the most important tendons in your leg. The main functions of the posterior tibial tendon are to hold up the arch of your foot and to support your foot when you walk.

Injury to the posterior tibial tendon may cause inflammation of the tendon–commonly called tendonitis. Injury or inflammation associated with posterior tibial tendonitis can prevent the tendon from providing stability. Posterior tibial tendonitis can also prevent the tendon from supporting the arch of the foot, causing flatfoot, a condition that causes the entire sole of your foot to touch the ground when you stand.

What causes posterior tibial tendon dysfunction?

A fall or other acute injury can tear your posterior tibial tendon or cause inflammation in this tendon. Repetitive use of the legs from playing high-impact sports, such as basketball, soccer, or tennis, can also inflame or tear the tendon. Torn or inflamed posterior tibial tendons can cause the arch of your foot to slowly collapse and fall over time.

Posterior tibial tendonitis symptoms

Posterior tibial tendonitis symptoms can include:

  • Pain along the inside of your ankle and foot near the affected tendon; pain may or may not be associated with swelling in the area.
  • Pain that gets worse with activity; running or other high-intensity or high-impact activities can be very difficult, but some people with posterior tibial tendon pain can have trouble just walking or even standing for a long time.
  • Pain on the outside of the ankle that develops when the foot collapses and the heel bone shifts to a new position outwards that puts pressure on the outside ankle bone.

How to treat posterior tibial tendonitis

See your doctor

Your doctor will review your medical history and symptoms then examine your feet and ankles, and order imaging tests before prescribing a personalized treatment plan.

Try non-surgical treatment

Decrease or stop any activities that worsen the pain. Wear a posterior tibial tendonitis brace to support the tendon. Apply cold packs to the painful area for 20 minutes three to four times each day to minimize pain; apply cold packs to the area after exercise to minimize inflammation.

Do stretches/exercises

Performing posterior tibial tendonitis exercises and stretches can improve the flexibility, overall strength and balance, and range of motion of your ankle. Posterior tibial tendonitis stretches include:

  • Runner’s stretch – lunge forward with your unaffected leg in front of the other; you can put your hands on your hips or place them on a wall as you stretch
  • Towel ankle stretch – sit on the floor with your legs straight and hold a towel around one foot, just under your toes, with both hands; pull back with the towel to stretch your foot towards you and hold for 15 to 30 seconds
  • Hamstring stretches – lie on your back in a doorway, with your good leg extending through the open door; slide the affected leg up the wall to straighten your knee and hold

Posterior tibial tendonitis recovery time is generally 6 to 8 weeks. Early activity on a healing tendon can set back recovery. For more information on posterior tibial tendonitis, consult with your doctor.