Tibialis Posterior Tendonitis

Tibialis posterior tendon dysfunction or TPTD is a term to describe a progressive flatfoot deformity in older adults.  The condition is essentially characterized by a gradual weakening and inflammation of the tibialis posterior tendon which is one of the main  supporters of the arch.  

Certain foot types seem to be predisposed to TPTD.  If a person has a foot that pronates or flattens excessively throughout their lifetime, there can be a gradual decrease in strength of all the ligaments, muscles and tendons that support the arch.  The soft tissues begin to stretch and as the condition progresses, there can be tearing of the TP tendon resulting in a loss of strength and further worsening of the condition.  The bones and joints begin to move out of proper position, the arch collapses further, and the heel may begin to turn inward due to the excessive pronation or flattening.

What we can do to help you solve this pain

If the pain doesn’t go away with ice and rest, or if the pain persists beyond a week, we would recommend that we see you as a patient.  It is important not to ignore the pain.  Tendonitis can become a chronic problem, and then becomes much more difficult to treat.

Initially, we will perform a complete history and physical examination of your foot.  A comprehensive biomechanical examination may be performed to see how your gait may contribute to the formation of the tendonitis.  Digital x-rays or an MRI might be ordered to rule out any other problems, such as a fracture or torn tendon.

Treatment will focus on relieving the pain and preventing further injury.  We will educate you on proper shoe gear and on avoiding certain activities that may be contributing to your pain.  We will discuss stretching exercises to help resolve your pain.  We may prescribe an oral or topical anti-inflammatory medication to help reduce the pain and inflammation from the tendonitis.  It may also be necessary to perform a cortisone injection to help reduce swelling.


Many cases of tendonitis respond very well to proper arch support or prescription orthotics.   If your tendonitis is mild, we may be able to use a pre-made arch support to control any abnormal flattening of your arch.  We carry arch supports in our office that are typically much better than what you will find in the store.  Some cases of tendonitis are more severe and may require the use of a prescription orthotic. This is a custom-made arch support that is made from a plaster impression or digital scan of your foot and arch. Unlike pre-made arch supports, however, an orthotic completely controls abnormal pronation or flattening of the arch.  Read more about custom orthotics​.  

If you are having symptoms consistent with tendonitis that are not improving, it is important to make an appointment to see us.  The doctors at Council Bluffs Foot & Ankle Care are experts in the cause and treatment of tibialis posterior tendonitis/dysfunction.  Call today to request an appointment.

320 McKenzie Ave., Ste. 102

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