My top 3 tips for treating tibialis posterior tendinopathy

Tibialis Posterior (Tib Post) tendinopathy or tendonitis is in my experience one of the more tricky tendon injuries to treat. The Tib Post muscle is located deep inside your calf and the Tib Post tendon runs from your calf down the inside of your ankle (behind the ankle bone) and attached to the navicular bone on the inside of your foot as well as to several other bones underneath your foot.

Its main job is to support your foot’s arch and provide stability to your foot. It also helps to point the foot down and turn it in.

Tib Post tendinopathy usually causes pain around the inside of the foot and ankle, but in severe cases it can also cause a rather intense ache a bit higher up from the ankle. In the video I provide a more detailed description of how you can tell if you have Tib Post tendinopathy and what causes this painful condition to develop.

1. Limit the time on your feet

My patients often find that standing for prolonged periods of time really aggravates this injury - often more so than walking or gentle jogging! Remember that the Tib Post’s main function is to help keep your foot’s arch up. So it works all the time that you’re on your feet.

I usually advise my patients, especially during the early stages of recovery, to limit how much they stand throughout the day. Sit down at every opportunity you can. This is just a temporary measure to allow your tendon pain to calm down and you’ll be able to build up to standing as much as you like once your tendon has recovered.

2. Get the right shoes and orthotics

Wearing shoes and orthotics that provide some passive support to your foot arch will also help to take some of the strain off the Tib Post tendon.

Try not to wear tight fitting shoes. When I had this condition, I found that even the pressure from my running shoe pressing on the tendon could make it ache. It really helped me to loosen my laces during the early stages of my rehab.

3. Don’t just strengthen the foot and ankle muscles

Yes, strengthening the muscles around your ankle and foot has been shown to help people recover from Tib Post tendinopathy, but you must also strengthen the rest of your leg. Weak glute and core muscles can cause your leg to turn in when you run and walk, placing extra strain on your Tib Post muscle and tendon. Check out the video above if you would like more information on this.

Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.

Best wishes

Maryke

About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn, ResearchGate, Facebook, Twitter or Instagram.

References:

1. Bowring B, Chockalingam N. Conservative treatment of tibialis posterior tendon dysfunction—A review. The Foot 2010;20(1):18-26.

2. Kulig K, Pomrantz AB, Burnfield JM, et al. Non-operative management of posterior tibialis tendon dysfunction: design of a randomized clinical trial [NCT00279630]. BMC musculoskeletal disorders 2006;7(1):1.

3. Ross MH, Smith MD, Mellor R, et al. Exercise for posterior tibial tendon dysfunction: a systematic review of randomised clinical trials and clinical guidelines. BMJ open sport & exercise medicine 2018;4(1):e000430.