Book Now

Posterior Tibial Tendinopathy Treatment in Halifax & Elland | Elland Foot Clinic

Pain on the inside of your ankle, swelling behind the ankle bone or an arch that seems to be getting flatter can all be signs of posterior tibial tendinopathy. Left untreated, it can make walking tiring and painful. At Elland Foot Clinic, we diagnose the problem early, support the arch and strengthen the tendon, so you can stay active.

Book an appointment
Condition

What Is the Posterior Tibial Tendon?

The posterior tibial tendon runs from the calf muscles down the inside of the ankle and attaches into the arch of the foot. Its role is to:
  • Support the arch during walking
  • Control foot motion
  • Stabilise the ankle and midfoot
  • Help the foot push off efficiently during movement

What Is Posterior Tibial Tendinopathy?

Posterior tibial tendinopathy occurs when the tendon becomes irritated, overloaded or degenerative due to excessive strain over time. In early stages, symptoms may involve pain and swelling along the inside of the ankle. More advanced cases may lead to progressive collapse of the arch and difficulty walking comfortably.

The tibialis posterior tendon runs from a muscle deep in your calf, around the inside of your ankle and under your foot. Its main job is to hold up the arch and control how your foot rolls in as you walk. When the tendon is overloaded, it becomes painful and can gradually lose strength.

Common Symptoms of Posterior Tibial Tendinopathy

  • Pain along the inside of the ankle
  • Tenderness around the tendon
  • Swelling near the inner ankle
  • Arch pain or fatigue
  • Progressive flattening of the foot
  • Difficulty standing on tiptoes
  • Pain worsening after walking or activity
row of legs of barefoot young dancer

What Causes Posterior Tibial Tendon Problems?

Several factors may contribute to tendon overload, including:
  • Flat feet or excessive pronation
  • Repetitive walking or standing
  • Increased body weight
  • Weakness within the lower limb
  • Tight calf muscles
  • Inappropriate footwear
  • Sudden increases in activity levels
  • Previous ankle injuries

Why Can The Arch Collapse?

The posterior tibial tendon plays a major role in supporting the arch during movement. If the tendon becomes weakened or dysfunctional, the foot may gradually roll inward excessively (pronate), placing additional strain on surrounding joints and soft tissues. Over time, this may lead to progressive flatfoot deformity and increasing instability.
foot and ankle treatment

How Is Posterior Tibial Tendinopathy Diagnosed?

At Elland Foot Clinic, assessment focuses on identifying both tendon irritation and underlying biomechanical contributors. Assessment may include:
  • Foot posture assessment
  • Examination of tendon tenderness and swelling
  • Single leg heel raise testing
  • Assessment of arch stability
  • Footwear evaluation
  • Lower limb biomechanical examination

Treatment Options for Posterior Tibial Tendinopathy

Treatment aims to reduce tendon strain, improve stability and restore lower limb function. Management may include:

  • Orthotics and arch support devices
  • Footwear advice
  • Tendon strengthening exercises
  • Calf rehabilitation programmes
  • Load management strategies
  • Activity modification
  • Biomechanical correction
  • Advice regarding walking and exercise progression

Why Footwear Is Important

Unsupportive footwear may increase strain on the posterior tibial tendon by allowing excessive inward foot motion. Supportive footwear with appropriate structure and stability may help reduce mechanical stress on the tendon during walking.

When Should You See a Podiatrist?

Professional assessment is recommended if:
  • Pain develops along the inside of the ankle
  • The arch appears to flatten progressively
  • Walking becomes uncomfortable
  • Swelling develops around the tendon
  • Standing on tiptoes becomes difficult
  • Symptoms are limiting exercise or daily activities

Symptoms to Look Out For

  • Pain and tenderness along the inside of the ankle and arch
  • Swelling behind the inner ankle bone
  • Pain that gets worse with walking, standing or exercise
  • A foot that rolls in more than it used to, or an arch that is dropping
  • Difficulty rising up onto your toes on the affected side

Why the Tendon Becomes Painful

It is often caused by a gradual build-up of load, such as more walking or standing than usual, weight gain, a change of footwear or naturally flat feet that make the tendon work harder. It is most common in adults from middle age onwards but can affect anyone.

The Link Between Posterior Tibial Tendinopathy and Flat Feet

Posterior tibial tendinopathy is one of the most common reasons an adult’s arch starts to flatten. As the tendon weakens, it struggles to hold the arch up, which adds even more strain. Treating it early gives the best chance of protecting the arch and avoiding long-term changes to your foot shape.

How We Assess Inner Ankle and Arch Pain

Nick will look at your foot standing and walking, check the strength of the tendon with a single-leg heel raise and feel along its path for tenderness. Our digital foot scanner then shows how your foot is loading and how much it is rolling in. This gives us a clear starting point and a way to measure progress.

Strengthening the Tendon

A tailored exercise programme is central to recovery. We start with exercises your tendon can manage comfortably and progress them over several weeks, building strength in the tendon, calf and small muscles of the foot.

Arch Support and Custom Phits Orthotics

Supporting the arch takes pressure off the tendon while it gets stronger. For many people we prescribe Phits custom orthotics, 3D printed from your foot scan to give support exactly where your foot needs it. Read more about our custom orthotics service.

Bracing for More Advanced Cases

If the arch has already started to collapse or the pain is severe, a short period in an ankle brace or walking boot may be needed to protect the tendon. We will discuss the options with you and refer you on if your foot needs a specialist surgical opinion.

A Flat Feet Specialist in Elland

Flat feet are not always painful, but when they are, the cause matters. As a musculoskeletal podiatrist, Nick Mainds assesses whether your flat feet are flexible or rigid, whether the posterior tibial tendon is involved and what support will actually help. Nick is HCPC registered (CH33550) and a member of the Royal College of Podiatry, so you are seen by a qualified, regulated clinician every time. Find out more about our wider MSK podiatry service.

Flat Feet and Ankle Pain Treatment Near Halifax, Brighouse and Huddersfield

Elland Foot Clinic is located in the Wellbeing Centre on Briggate, Elland (HX5 9DP), within easy reach of Halifax, Brighouse, Huddersfield, Rastrick and the surrounding villages. You can book online in a few clicks or call 07377 371070.

Posterior Tibial Tendinopathy FAQs

Can posterior tibial tendinopathy worsen over time?
Yes. Without appropriate management, the tendon may weaken further and contribute to progressive arch collapse.
Excessive pronation and flatfoot mechanics commonly increase strain on the tendon.
Orthotics may help support the arch and reduce excessive strain on the tendon.
Strengthening and rehabilitation exercises are often important components of recovery.
Persistent inner ankle pain should be professionally evaluated to identify tendon involvement and prevent progression.

No. Many people have flat feet all their lives with no pain at all. Treatment is only needed when flat feet are causing pain, tiredness or problems further up the leg, or when an arch is changing shape.

An adult’s foot shape cannot usually be permanently changed without surgery, but symptoms can be managed very well. Orthotics, supportive footwear and strengthening exercises can reduce pain and help your foot work more efficiently.

An arch that is flattening in adulthood is often linked to a weakening posterior tibial tendon. It is worth getting checked early, as treatment is simpler and more effective in the early stages.