The posterior tibial tendon is an important leg tendon that attaches the calf muscle to the inside foot bones, keeping the arch in its position and providing support when walking. The tendon commonly becomes torn or inflamed due to overuse, high-impact sports, and falls, which can result in flatfoot, instability, and decreased arch support over time.

Posterior tibial tendon dysfunction causes symptoms such as pain that increases with activity and generally occurs at the tendon’s location, swelling along the tendon, difficulty bearing weight on the foot and ankle, and outer ankle pain as the foot collapses. Treatment includes rest with no high-impact exercise or sports, ice, anti-inflammatory medication (check with a doctor before taking any medication), immobilization through a cast or walking boot, orthotic shoe inserts that help position the foot and accommodate foot shape changes, braces, physical therapy, and cortisone shots. Surgery may be necessary for reconstruction if the above treatments do not alleviate the symptoms and pain after an extended period of time.