Tibialis Posterior Muscle Dysfunction

Posterior Tibial Tendon Dysfunction

Tibialis Posterior Muscle Dysfunction is a common and disabling foot and ankle problem affecting mainly women aged over 40 and generally presents as pain on the inside of the arch and ankle together with a ‘collapsed arch’ and rolled in ankle appearance.

As this condition is progressive and disabling, it is essential that an early and correct diagnosis is made to halt its progress and symptoms. Balance Podiatry has treated thousands of people with this condition. There are specific tests and specific orthotic prescription variables to manage this condition and provide relief.

This tendon serves as one of the major supporting structures of the foot and helps the foot to function while walking. In PTTD the tendon’s ability to perform that job is impaired, often resulting in a flattening of the foot. This condition has also been referred to as adult acquired flat foot (AAFF), is recognition that once the posterior tibial tendon has lengthened, other static and dynamic supporters of the foot are also strained and damaged (including the spring ligament, plantar fascia and plantar tarsal ligaments) resulting the flat foot.


  • Pain,  tenderness or swelling on the inside of the shin, ankle or foot
  • Flattening of the medial longitudinal arch of the foot
  • Tibialis posterior aching and muscle fatigue

With appropriate and rapid treatment the progression of this condition can be slowed considerably or in some cases even ceased. Depending on the stage and acuteness of the presenting case, treatment can vary but will include one of more of the below:

  • Short term immobilisation is often beneficial
  • Orthotic devices
  • Above ankle articulation braces
  • Shoe advice and modifications
  • Physical therapy
  • Medications
  • Surgery if indicated