posterior tibialis

Medial (inside) Ankle Pain

If you have experienced inside calf, ankle and foot pain, posterior tibialis tendonopathy may be the culprit! This is often misdiagnosed or missed out completely. Yet it is a common structure that is irritated particularly in running – due to the biomechanics.

Posterior Tibialis Anatomy

It is important to understand the muscle, in order to better understand the injury, and then effectively treat the condition. Posterior tibialis originates from the upper 2/3 posterior (back) of the tibia and also  the upper 2/3 medial (inside) surface of the fibula.

The tendon then is formed and travels down the back and medial (inside) malleolus (ankle bone) within a groove and then it splits into a medial and lateral portion. These tendons then attach underneath the midfoot.


Posterior Tibialis is a key muscle for stabilisation of the foot. It contracts, together with other muscles, to produce inversion  (turning foot inwards) and plantarflexion (push foot downwards).

It’s major role is supporting the medial (inside) arch of the foot.

posterior tibialis

Differing Diagnoses

Posterior tibialis is best assessed by a Physiotherapist in order to confirm, or rule out, this condition. There are other conditions, which may have similar symptoms:

Similar…but not the same

Plantar fasciitis can be experienced together with posterior tibialis tendonopathy. They are closely linked and you need a careful diagnosis to:

  • Distinguish between the two
  • Recognise if you are experiencing BOTH conditions
  • Treat appropriately depending on the findings.

The tips to prevent these conditions as well as manage them are similar to what I have written in my blog on plantar fasciitis. However, some of the advice and hands – on treatment will differ between these two conditions. If you are unsure,  get assessed and treated by a Physiotherapist.