The posterior tibial tendon runs along the inside of the ankle and attaches to the navicular bone in the foot, where it helps support your arch. Tendonitis here comes from overuse, and is closely tied to over-pronation — when the arch flattens more than normal during walking or running, straining the tendon with every step.
Recognizing it
Pain and tenderness along the inner shin, ankle, or foot, worse when lifting the foot, walking, or running. A clinician may watch you walk or run to check for over-pronation as part of the exam.
Early management
Ice (including ice massage) for 20–30 minutes, elevation, and anti-inflammatory medication. Arch supports — either over-the-counter or custom orthotics — and taping the foot to support the arch and tendon are common and often central to recovery, since they directly address the over-pronation driving the problem. A short period in a cast or using crutches is sometimes needed for more painful cases.
Rehab progression
- Mobility: towel stretch and standing calf stretch to ease tension on the tendon.
- Resisted inversion: turning the foot inward and downward against light band resistance — directly targeting the posterior tibial tendon’s own action.
- Heel raises once tolerated, to rebuild overall calf and ankle strength.
- Balance work: single-leg standing balance, progressing to reaching drills, to restore arch control under load.
Return to sport once you have full strength and range of motion matching the uninjured side, and can jog and sprint without pain or limping.
Posterior tibialis tendinitis rehab exercices
This page is educational and general in nature and does not replace an individualized evaluation — see our medical disclaimer.