Posterior Tibialis Dysfunction (Medial Arch Pain)

Posterior Tibialis Tendon is an important structure of the foot. It helps provide support for the arch of the foot when walking and standing. If the tendon becomes painful, it gives very specific pain in the inner side of the arch.  Typically, the Tendon becomes painful in response to overloading – either due to changes in the Tendon over time, or to a change in activity/footwear.

There are two mechanisms how this can occur:

1. Acute Onset – This is usually due to a change in activity i.e. started a new hobby, ran or walked for a prolonged period then normal, new gym routine. This often starts either just after, or a few weeks into the programme.
2.  Chronic Onset – This is usually pain which builds over time, more of a gradual onset with no recent change in activities.
This page will give advice on how to manage both types of Posterior Tibialis pain.  Should your foot pain not improve within the first few weeks of trying we would recommend seeking an assessment from a health professional.

 

 

Acute

This pain is usually reactive from a change in activity or change in footwear. This type of pain usually comes on quickly and can be often be traced back to the change. At this stage appropriate footwear is key to help offload the Tendon to allow the inflammation settle. It is advisable to wear good well-structured and supportive footwear. Those which are laced and have a suitable wide sole tend to be more comfortable (e.g. running trainer, brogue).

If you are experiencing foot and ankle pain you may find that wearing flat soled shoes (e.g ballet pumps) or walking barefoot will increase your symptoms; therefore, it is advisable that if you do have ongoing pain to increase the amount of time spent in structured supportive shoes.

Reducing high loading activities such as running and jumping short term will also allow the irritation to settle. Regular stretching of the muscles of the lower limb and ensuring good range of movement at the ankle will ensure that the weight put onto the foot when standing/walking/running is being distributed efficiently. Should symptoms persist, and no improvement is seen after 4-6 weeks then it is advisable to seek an assessment and further advice.

Below are some exercises to try and help if you’re suffering from a sudden onset of pain in your arch.

To download some useful exercises click here.

Chronic

This type of pain starts more gradually, with no real trigger. This pain is more likely caused by changes in the Tendon as we get older, and/or changes in the way the foot as a whole is loaded by your bodyweight.

Foot wear is important – it can help offload the Tendon. It is advisable to wear good well-structured and supportive footwear. Those which are laced and have a suitable wide sole tend to be more comfortable (e.g. running trainer, brogue).

The exercises we give will include activation and loading work to help strengthen the tendon itself and re-introduce more typical movement further up the lower limb such as the hip and bum muscles. The exercises below can help. If your symptoms are not improving after 6 weeks, or you cannot complete these without significant pain and discomfort then a review from a health professional is recommended.

To download some useful exercises click here.