Tibialis Posterior Tendinopathy (ankle pain) – what is it, and how can you fix it?!

It’s a hell of a name – Tibialis Posterior Tendinopathy but in essence, it’s typically a long-term pain on the inside of the ankle bones or the foot and can occur from either overuse, or an acute injury. It is a very common presentation that we as physiotherapists see and it left untreated, can lead to long term flat feet. It is more common to occur on one side, as opposed to both feet.

The tibialis posterior muscle runs from the back (posterior) of the shin bone (tibia) to insert onto the navicular bone, located in the middle of the foot. It’s major role is to stabilise the foot when walking or running by supporting the arch of the foot. It also acts to pull the foot inwards, plus play a small role in propelling the foot forwards when walking or running. Typically, we see clients present to us with pain at the inside of the ankle. It is often sore first thing in the morning or at the start of a run, but then eases during activity or throughout the day. Then, it gets particularly sore in the ankle again after you’ve cooled down or sat still for a few hours again.

When there is a chronic or overuse cause for the pain, it usually occurs because the load we are requiring of the tibialis posterior muscle is too much for the strength capacity it has. This doesn’t mean we are exercising too much; it just means we are exercising too much for the muscle at the moment. Therefore, the treatment is a simple one and often a combination of two things:
1. Increase the strength of the muscle
2. Reduce the load going through the foot and ankle

To strengthen tibialis posterior, some of the key exercises to complete are:
1. Calf raises – standing on one foot and lifting your heel off the floor to its maximal height
2. Ankle inversion with resistance – Sit with your leg out straight and resistance band around the foot. Slowly and controlled, pull the foot in towards the midline of the body and back to neutral again
3. Double leg calf raise (with ball) – stand while holding onto a ball (basketball/soccer ball/netball) between the ankles and lift the heels off the floor, going up onto your tip toes. Slowly return back down again to the floor.

Whilst these can be some of the options available to you to rehabilitate and resolve pain on the inside of the foot and/or ankle, this explanation is by no means a complete list. There are a number of things our physiotherapists can continue to do to resolve your injury. Some of these may include taping or bracing, massage, dry needling or ankle mobility exercises. If you are experiencing pain, please speak to one of our Instinct Health physiotherapists about how we can fix your pain, and get you moving again!

Don’t forget to check out our Pilates and massage services while you’re here!

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The Anatomy of the Shoulder

Tibialis Posterior Tendinopathy (ankle pain) – what is it, and how can you fix it?!