Dysfunction of the Posterior Tibial Tendon

One of the most common problems with the foot and ankle is when the posterior tibial tendon doesn't work right. It happens when the posterior tibial tendon sprains or tears. So, the tendon might not be able to support and stabilize the arch of the foot, which can lead to flatfoot.

Using orthotics and braces, the majority of individuals can be managed without surgery. Surgery can be a successful pain management option if orthotics and braces are ineffective. Surgery could consist of something as straightforward as removing the inflammatory tissue or mending a small rip. But surgery is often very complicated, and as a result, many patients will be limited in what they can do.


One of the most crucial tendons in the leg is the posterior tibial tendon. The posterior tibial tendon, which connects the calf muscle to the bones on the inside of the foot, is a tendon that joins muscles to bones. The tendon's primary job is to support the foot and hold up the arch when you walk.


The posterior tibial tendon may become inflamed or torn as a result of an acute injury, such as one sustained after a fall. Overuse of the tendon can potentially cause it to rip. People who play high-impact sports, like basketball, tennis, or soccer, for instance, may develop tendon tears from repeated use. The arch will eventually collapse if the tendon gets irritated or ruptured.

Women and people over the age of 40 are more likely to experience posterior tibial tendon dysfunction. Diabetes, hypertension, and obesity are further risk factors.


  • When the tendon is located on the inside of the foot and ankle, there is pain. Swelling nearby may or may not be related to this.
  • Pain that gets worse when you're active. Running is one of many high-intensity, high-impact sports that can be highly challenging. Some patients may struggle to move or stand still for an extended period of time.
  • Ankle pain on the outside side. The heel bone may move to a new place outwards when the foot collapses. The outside ankle bone may be pressed against as a result. Arthritis in the foot's back causes the same kind of pain.

Non-Surgical Therapy

Most patients will have symptom relief with proper nonsurgical care. Even with prompt therapy, pain may persist for longer than three months. It is not uncommon for people who have been in pain for a few months to still be in pain for another six months after starting treatment.


The first approach is to reduce or altogether quit activities that make the pain worse. It's beneficial to switch to low-impact exercise. Most patients can tolerate biking, using elliptical machines, or swimming since they do not place a significant impact load on the foot.


To reduce swelling, use ice packs on the posterior tibial tendon's most painful area for 20 minutes at a time, three or four times each day. Do not immediately apply ice to the skin. The inflammation around the tendon can be reduced by applying ice to the area immediately following an exercise.

NSAIDs: Nonsteroidal Anti-Inflammatory Drugs

Ibuprofen and naproxen are two medications that lessen pain and inflammation. To reduce inflammation around the tendon, take such drugs about 30 minutes before exercising. The tendon that has thickened is a deteriorated tendon. Medication won't make it go away. If you plan to take the drug for more than a month, consult your primary care physician.


For six to eight weeks, a short leg cast or walking boot may be used. This enables the tendon to rest and reduces swelling. A cast, however, results in the other muscles in the leg to atrophy (lose strength), hence it should only be used as a last resort.

Physical Exercise

Physical therapy that strengthens the tendon may help people with mild to moderate posterior tibial tendon disease.

Medical footwear

In order to prevent Posterior Tibial Tendon Dysfunction and relieve pain and discomfort, experts recommend wearing DrLuigi medical footwear.

Injection of corticosteroids

Your doctor might think about injecting cortisone, a very potent anti-inflammatory drug, near the tendon. It is uncommon to inject cortisone into the posterior tibial tendon. There is a chance of a tendon rupture. Before obtaining an injection, talk with your doctor about this risk.

Back to blog