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Tibialis Posterior Dysfunction

Where Is The Tibialis Posterior Muscle Located?

The tibialis posterior muscle is is located within the deep posterior compartment of the lower leg.

The Tibialis Posterior is a key stabilisinging muscle supporting the medial arch of your foot.

All the calf muscles are shown in the image on the right, however, the image on the left is stripped back to show only the deep calf muscles and the tibialis posterior is highlighted.

Why is the Tibialis Posterior Muscle Important?

The tibialis posterior muscle aids in plantar flexion and inversion of the foot and ankle joint.

It is also responsible for stabilising the medial longitudinal arch of the foot.


What Causes Posterior Tibial Tendon Insufficiency?

One of the major causes of tibialis posterior insufficiency is abnormal biomechanics causing repetitive loading on the muscle and tendon leading to microtrauma and progressive failure.

There are certain risk factors for tibialis posterior dysfunction including diabetes, obesity, repetitive trauma, psoriatic and rheumatoid arthritis, steroid therapy (including steroid injections), young athletes, people with poor biomechanics and flat feet.

Tibialis posterior dysfunction is more common in the elderly and middle aged women. It is commonly referred to as adult acquired flatfoot deformity.

Treatment of Tibialis Posterior Tendon Dysfunction

Posterior tibial tendon dysfunction is a debilitating condition if not treated in the early stages. Effective treatments are listed below:

    Tibialis Posterior Strengthening Exercises

    One of the simplest exercises for strengthening your tibialis posterior muscle is a ball squeeze as this exercise involves both plantarflexion and inversion which are the primary actions of your tibialis posterior muscle.

    1. Find a ball around 14 – 20cm in diametre
    2. Place the ball in between your ankles with both feet pointing straight ahead
    3. Begin by squeezing the ball between your heels
    4. While still squeezing the ball, raise your heels off the ground so you are standing on your toes, keep squeezing the ball.
    5. Pause on your toes, keep squeezing the ball for 4 seconds
    6. Slowly lower your heels to the ground continuing to squeeze the ball
    7. When you have reached the starting position release the squeeze on the ball
    8. Repeat steps 1-7, 12 – 15 times at least twice a day
    Dry Needling

    Dry needling is an effective treatment for the tibialis posterior muscle, whereby a tiny needle is inserted directly into the tibialis posterior muscle’s trigger point consequently releasing tension within the muscle belly.

    It may also be necessary to treat the surrounding muscles such as the flexor digitorum longus and the flexor hallucis longus muscles and also the counter acting muscle, the tibialis anterior muscle.

    Your podiatrist will then prescribe very specific stretching and strengthening exercises for you to perform at home.

    Functional Orthotic Therapy

    If you present with tibialis posterior tendon dysfunction at Erica Dash Podiatry, it is likely your podiatrist will recommend functional foot orthoses.

    Our functional foot orthoses will correct the position on your subtalar joint and prevent flat foot deformity.

    A podiatrist will assess your lower extremity and gait and successfully prescribe and fabricate an orthotic which will enhance the position of your navicular bone and support your medial longitudinal arch.

    When wearing your orthotic daily, your soft tissues adjust and aid your muscle function.

    Shockwave Therapy

    Shockwave therapy is an effective treatment for chronic pain of the posterior tibial tendon. When the tendon becomes injured, we call it tendinitis, which doesn’t last very long.

    Following tendonitis is a condition called tendinosis which is more difficult to treat.

    Radial Shockwave Therapy stimulates healing in the tendon by creating pressure waves.

    It is these pressure waves that stimulate healing by creating formation of new blood vessels and also releasing proteins to promote healing of the tissues.

    Shockwave therapy takes time, often as long as 4 months to create a positive result. Shockwave therapy is an effective, safe, non – invasive and relatively painless treatment option.

    Surgical Intervention

    Tibialis Posterior Tendon Surgery may be performed if the deformity in your foot is chronic and unresponsive to other forms of treatment.

    Surgical management of tibialis posterior tendon repair varies due to the extent of damage in the tendon so it is best to speak to your orthopedic surgeon or podiatric surgeon regarding their choice of technique.

    Shockwave Therapy

    Shockwave is a great alternative to treatments such as dry needling if you’re needle phobic and not keen on dry needling. We also have effective treatment offers for kids.

    Learn More


    If you experience foot, knee or leg pain in your daily activities then a professionally fitted custom orthotic could be the answer to your foot problems.

    Learn More

    Dry Needling

    Dry needle therapy can be very effective in treating a range of conditions including chronic muscle pain, neuromuscular problems, and sports injuries.

    Learn More

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    Erica Dash Podiatry is family friendly treating a wide range of foot and leg complaints of patients of any age or stage of life - See All Podiatrists

    Leaders in lower limb care embracing the whole family…
    Call us at 02 4367 0177 or fill out our online contact form to schedule your podiatry appointment today!

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    225 Central Coast Hwy,
    NSW, 2250

    02 4367 0177

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