Skip to main content

Tibialis Posterior Dysfunction

Find out about diagnosis of tibialis posterior dysfunction, and how it can be treated by experts

Tibialis posterior dysfunction is a condition causing pain over the inside of the lower calf and ankle. It arises when the tibialis posterior tendon is unable to provide sufficient support to the arch of the foot.

It is often due to a tear or a generalised weakening and elongation of the tendon. Sometimes the tendon itself remains intact but the problem is caused by significant inflammation of the sheath which surrounds the tendon. In this case, the problem can be referred to as a tenosynovitis. Individuals with an inherently flat foot posture (which places the tibialis posterior under greater load) are particularly vulnerable to developing a tear or elongation to the tend.

Pain is located just behind and below the inside bone of your ankle which often tracks towards the inside arch of your foot. There may also be swelling and some individuals may experience a creaking (known as crepitus) with certain movements of the ankle.

Symptoms are aggravated with any activity which requires repeated use of the calf muscles for propulsion such as in walking and running. The arch of the foot may become flatter and the ankle may lean inwards.

Tibialis posterior dysfunction can be reliably diagnosed by your doctor or physiotherapist by taking a history of your condition and by conducting a physical examination. The main feature on examination is often pain and swelling over the tendon on palpation as well as pain when contracting the tibialis posterior muscle.

If there is a suspicion of a significant tear to the tibialis posterior tendon, your clinician may request an ultrasound scan to guide your management appropriately.

Initial Management

It is usually necessary to rest, or at least reduce the amount of activity, for a short while to help the symptoms settle. Applying an ice pack for 5-15 minutes every 2-3 hours may provide some relief. You may wish you try over-the-counter painkillers such as paracetamol if needed.

Exercises

Once the acute pain has settled, a tibialis posterior dysfunction can be managed effectively by adhering to the following advice and exercise routine to strengthen the tibialis posterior muscle and tendon.

[Gastric heel exercises video] https://youtu.be/ZPjDtNJa02U

3 x 15 repetitions 2x per day

Footwear

You should ensure that you use well-fitting, supportive footwear with adequate arch support, both during your everyday activities and, particularly, during exercise. Very flat shoes and high heels can also exacerbate the problem. Orthotic inserts placed inside your shoes can ensure better foot position, which should prevent the problem recurring.

Further options

If there is a severe tear or rupture, total rest in a cast or boot may be required.

Surgical management

Surgical repair is occasionally considered in severe cases.

Specialists Offering Tibialis posterior dysfunction

Mr Nitin Modi

Consultant Orthopaedic Surgeon

MBBS, MS Orthopaedics FRCS (T&O), MS Orthopaedics, MRCS, FCPS Orthopaedics, Diploma Orthopaedics

BMI St Edmunds Hospital

View profile Book online

Mr Ashok Marudanayagam

Consultant Orthopaedic Surgeon

MBBS, Dip Ortho, DNB (Ortho), FRCS (Glasg), FRCS (Tr & Orth)

BMI The Lincoln Hospital

View profile Book online

Mr Garth Allardice

Consultant Orthopaedic & Trauma Surgeon

MBBCh(WITS), FCS(SA), Orthopaedics

BMI Bishops Wood Hospital 2 more BMI The Clementine Churchill Hospital BMI Syon Clinic

View profile Book online

Mr Sunil Dhar

Consultant Orthopaedic Surgeon

MBBS MSOrth MCh Orth FRCS Ed FRCS Orth

BMI The Park Hospital

View profile Book online

Mr Laurence James

Consultant Trauma & Orthopaedic Surgeon

BSc (hons), MBBS, MRCS (Eng), FRCS (Tr & Orth)

BMI The Blackheath Hospital 2 more BMI Chelsfield Park Hospital BMI The Sloane Hospital

View profile Book online

Mr Satyajit Naique

Consultant Orthopaedic & Trauma Surgeon

FRCS (Tr&Orth), MS, FRCS, FCPS, Dip (Orth), DNB, MBBS

BMI Bishops Wood Hospital 1 more BMI The Clementine Churchill Hospital

View profile Book online

View all

Ways to pay

credit card

Pay for yourself

Pay for yourself with our fixed price packages. This includes your pre-assessment, treatment, follow-ups and 6 months' aftercare

Find out more

insurance

Pay with health insurance

We are widely recognised by health insurers. Ask your insurer about your cover and for an insurer pre-authorisation code

Find out more

direct debit

Spread the cost

Pay for yourself with the BMI card and spread the cost over 12 months, interest-free (terms and conditions apply)

Find out more

General Enquiries