The tibialis posterior muscle is located on the inner side of the shin, halfway up the lower leg. It runs downward along the inside of the heel, where its tendon attaches at the base of the foot arch.
The main function of the tibialis posterior muscle is to move the foot and ankle downward and inward toward the body’s midline. It also plays a crucial role in supporting and maintaining the arch of the foot.
Tendinopathy is a term used to describe painful conditions affecting the tissues surrounding a tendon, often due to overuse.
What are the symptoms?
Symptoms of tibialis posterior tendinopathy may include:
- Pain or stiffness along the tendon.
- Clicking or ‘crepitus’ sounds during movement.
- Swelling.
Pain can be felt when touching the tendon or when performing activities that engage the tibialis posterior muscle, such as rising onto tiptoes, hopping, or running. As the condition progresses, the weakened tendon may provide less support to the foot arch, leading to noticeable discomfort over time.
As tendinopathy advances, pain can become severe enough to hinder running and even walking. In some cases, the tendon may weaken without causing pain, but a complete tear could occur suddenly.
What are the causes?
The primary causes of tibialis posterior tendinopathy include:
- Overuse from prolonged or repetitive activities.
- Biomechanical issues, such as excessive foot pronation (rolling inward) during walking.
- Inadequate footwear that fails to support the foot arch.
Factors like obesity, muscle weakness or tightness, insufficient warm-up, and inadequate recovery periods can also contribute to this condition. Runners and athletes who engage in high-impact sports are particularly susceptible, but everyday activities can also lead to tendinopathy.
How can physiotherapy help?
Physiotherapy offers several ways to assist with tibialis posterior tendinopathy. Your physiotherapist can begin by accurately diagnosing the condition in clinic, often confirming it with MRI or ultrasound scans. They can also pinpoint contributing factors and develop strategies to alleviate pain promptly.
Treatment typically involves a period of relative rest followed by a structured training program designed to strengthen the tendon, which has shown the most effective results in recovery from tendinopathies. Additional therapeutic approaches may include ultrasound, ice or heat therapy, soft tissue massage, stretching exercises, and joint mobilization. Your physiotherapist may also recommend arch support taping, biomechanical adjustments, bracing, and footwear modifications to support healing and prevent recurrence.
None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.