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Posterior Tibialis Tendonitis

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Complaints

Possible Causes

Shoe Profile

The shoe midsole should provide maximum torsional and hindfoot stability to control medial foot rotation (pronation / arch drop). This reduces the tractional (pulling) forces that aggravate the posterior tibial tendon. A midsole with a high to medium heel-to-toe ratio is needed to relax tension on the tendon.

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Orthotics

Neutral to mild pronators – 3 mm heel lifts with, or without, over-the-counter arch supports
Moderate to excessive pronators – Custom orthotics with 3 plus mm heel lifts

Recommended Accessories

SuperFeet arch supports

Provides stability and support to the foot reducing pronation and eases tension on the tibial tendon.

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Heel Lifts

Simple way to reduce tension on the posterior tibial tendon resulting in less pain. Must be worn in both shoes.

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ProStretch for calf muscles

Very effective way for stretching the calf complex, which includes the posterior tibial muscle. Increased flexibility reduces the chance of injury.

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The Stick

Effective way to massage for releasing muscle tension and reducing pain and tenderness.

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TheraBand Kit

Handy for developing an exercise strengthening program.

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SKLZ Cold Roller Ball

Provides targeted massage and ice therapy to provide relief and reduce inflammation.

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Exercises

**Please consult your physican before engaging in an exercise program.**

With all strengthening exercises, start with 3 sets of 10 repetitions. If you experience any sort of pain reduce your reps to 3 sets of 5. For all stretches, repeat 3 times holding each stretch for 30 seconds to 1 minute. Using RICE (Rest, Ice, Compression, Elevation) can be beneficial in the treatment of injuries as well.

Gastrocnemius (calf) Standing Stretch
Soleus Standing Stretch
  1. Stand with hands resting on wall or on stable object.
  2. Place the UNINVOLVED leg forward of involved leg.
  3. Keep the back leg (involved leg) straight and heel on the ground throughout the exercise.
  4. Lean body forward bending at ankles and hold.
  5. Return to starting position, relax, and repeat
  1. Stand with hands resting on wall or on stable object.
  2. Place the UNINVOLVED leg forward of involved leg.
  3. Keep heel on the ground throughout the exercise.
  4. Bend knees, squat down, and hold.
  5. Return to starting position, relax and repeat.
Heel Raises Exercise
Foot Down and In Elastic Exercise
  1. Stand next to a wall or a chair with both feet on the ground pointing straight ahead.
  2. Push front of foot down lifting heels and body weight onto balls of feet.
  3. Slowly return to starting position and repeat.
  1. Place knot of elastic (Theraband) in door jamb about one foot up from the floor.
  2. Sit on floor with leg out straight and attachment of elastic outside and above the foot.
  3. Place elastic around inside of foot just below the toes.
  4. Move down and away and out away from attachment of the elastic to pick up slack.
  5. Push the foot down and in away from attachment of the elastic and hold.
  6. Slowly return to the starting position and repeat.
Foot Up Elastics Exercise
  1. Place knot of elastic (Theraband) in door jamb about one foot up from the floor.
  2. Sit on floor with leg out straight and attachment of elastic at the bottom of the foot.
  3. lace elastic around inside of foot just below the toes.
  4. Back up to pick up slack of elastic.
  5. Pull foot up keeping knee straight and hold.
  6. Slowly return to the starting position and repeat.
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Images reproduced courtesy of T.E.D.© (Therapeutic Exercise Database) V. 2.0
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