Any advice on posterior tibial tendon problem?

Hi there, I'm new to the forum, but been running since July 2017.

I have had a problem with pain in my left ankle for the past 6 months, and having taken 4-5 months off running (with the occasional short run) I recently started again, and the pain is starting to come back already (after only 5 runs) and I'm not sure what to do.

It seems to be a problem with the posterior tibial tendon, as the pain is just below the inner ankle on the left foot, and is noticeably worse when running uphill. I don't however have any trouble or discomfort when doing single leg calf raises, which everything online says is a posterior tib issue. I also don't have flat feet (yet!).

When I initially noticed the problem it didn't seem too bad, so I tried to carry on with my running and doing some calf stretches, and also got a stretch band and foam roller, but ended up struggling to walk the day after a 5 mile run, so had to take a break, which ended up being about 4-5 months.

I really want to get back into running, especially I've just signed up for my first half marathon in October, but I'm worried this ankle problem will stop me progressing, and I'm struggling to find any helpful advice online.

I had a gait analysis done at a running shop when I first noticed the pain, who said I have a neutral gait, and I got some much more cushioned shoes, which seemed to help at first, but the pain returned within about a week, so I don't think it's a shoe problem.

I'm concerned that 4 months rest has not resolved the issue, and am wondering if this is this likely to be something that some stretches and strengthening exercises could solve? Thinking of seeing a physio soon, but reluctant as they all seem expensive and I'm still a student, but I will do if it comes to it.

It would be great to know if anyone has had a similar problem, and what they did to resolve it?

I'm feeling pretty down at the minute about it as I enjoy running so much, I don't think I can cope with having to take another few months off only for the injury to come straight back again!

Best Answer

  • MsEMsE ✭✭✭
    Accepted Answer
    Without really wanting to diagnose, I thought I would post as I didn't want to leave your question wafting in the wind without an answer.  I have dealt with posterior tibial tendon issues and this article, to me, is a fairly comprehensive summary of what it means and ways in which to approach it. As ever, not one size fits all though which is why asking a group of strangers on the internet for advice on injuries can be tricky.  I hope you find a solution.  Above all, take your time to work out what your trigger was.  For me (1) with my right foot simply reducing pace and inserting temporary orthotics solved the issue within days (2) with my left foot, I have had to alternate using temporary orthotics (rotating shoes), work on strengthening the foot and have neurokinetic therapy to release the peroneal tendon and activate the posterior tib tendon.  Plus work on core stuff (it is all connected).  Several weeks later I have turned a corner. But I am not counting my chickens and am fastidious about the homework I have to do.  Good luck!


  • Thanks a lot for your response, it's good to know someone's managed to overcome a similar issue. And thanks for the article too!

    I'm booked in with a physio for this coming Wednesday so hopefully that will help shed some light on the possible cause(s).
  • MsEMsE ✭✭✭
    Hopefully the physio will look to see what is inhibiting the problem too e.g. the calf or peroneal.  It's just your body telling you something is up somewhere (not there) so you have to work it out!
  • Thanks, the physio session went really well, he took all sorts of measurements of my legs to check my flexibility etc, and gave me some stretches and gym exercises to do until my next appointment in 2 weeks, as he said my left leg is slightly worse than the right (particularly the calf), but that both could be better. Seems really positive and is confident we'll get it sorted fairly quickly. Oh and he diagnosed it as posterior tibial tendon strain, rather than tendonitis, and thinks it could be caused by imbalances between my legs possibly from a growth spurt when I was younger. I'm only 23 and have never taken up sport very seriously until recently, so it all seems to make sense.
  • MsEMsE ✭✭✭
    Delighted for you.  Make sure you do your homework now!
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