Posterior Tibial Tendinopathy

Posterior Tibial Tendinopathy treatment at KL Foot Specialist Podiatry in Sri Petaling, Kuala Lumpur — expert podiatric care for inner ankle pain and collapsing arches using gait analysis, orthotics, and rehabilitation to restore foot function

What Is Posterior Tibial Tendinopathy?

Posterior tibial tendinopathy (PTT) refers to inflammation, degeneration or tearing of the posterior tibial tendon — a crucial tendon that runs down the inside of your lower leg, behind the ankle bone, and attaches to the arch of your foot. This tendon plays a vital role in supporting your foot’s arch and allowing smooth and stable foot motion when walking or running.

If this tendon becomes overused, weakened, or injured, it can lead to pain, swelling, and even progressive arch collapse — a condition sometimes known as adult-acquired flatfoot deformity.

Causes Of Posterior Tibial Tendinopathy

Posterior tibial tendinopathy is typically caused by overuse, improper foot mechanics, or structural weaknesses in the foot. Common contributing factors include:

  • Flat feet or overpronation (when your arch rolls inward excessively)

  • Sudden increase in walking, running or standing activities

  • Weakness in supporting foot and leg muscles

  • Poor footwear or lack of arch support

  • Obesity or increased body weight

  • Previous ankle injuries or instability

  • Tight calf muscles or Achilles tendon

  • Inflammatory conditions such as rheumatoid arthritis

Symptoms Of Posterior Tibial Tendinopathy

The condition often starts gradually, with mild pain that worsens over time. Common symptoms include:

  • Pain and swelling along the inside of the ankle and foot

  • Tenderness along the posterior tibial tendon pathway

  • Pain during activity (especially walking, running or standing for long periods)

  • Pain that worsens when walking uphill or climbing stairs

  • Flattening of the arch (in more advanced cases)

  • Ankle instability or weakness

  • Difficulty standing on tiptoes on the affected side

If left untreated, this condition can progress to permanent flatfoot deformity and loss of function.

Diagnosing Posterior Tibial Tendinopathy

At KL Foot Specialist Podiatry, diagnosis starts with a detailed history and clinical examination. We assess your foot posture, muscle strength, arch structure, ankle range of motion, and walking pattern (gait analysis).

We may refer for ultrasound or MRI imaging to confirm the diagnosis, check for partial or complete tears, and evaluate the condition of surrounding structures. Early detection is key in preventing long-term foot damage and improving outcomes.

Treatment for Posterior Tibial Tendinopathy

Your treatment plan will be tailored to the severity and stage of your tendinopathy. Most cases can be treated non-surgically with the right combination of therapy, support, and activity modification.

Initial Management

  • RICE Protocol: Rest, Ice, Compression and Elevation to reduce pain and swelling

  • Activity modification: Reducing or avoiding aggravating movements like running, jumping or prolonged standing

  • Supportive footwear: Cushioned shoes with arch support and rearfoot control

  • Temporary ankle bracing or strapping to offload the tendon

Core Podiatry Treatments

  • Custom foot orthotics: Our podiatrists may prescribe orthotics designed to offload pressure from the damaged tendon, improve arch alignment, and provide optimal support during movement

  • DolorClast® High Power Laser Therapy: A safe, painless treatment that promotes tendon healing, reduces inflammation, and accelerates recovery

  • DolorClast® Shockwave Therapy: Stimulates blood flow and tissue repair in chronic or slow-healing tendinopathies

  • Stretching and strengthening program: Targeted exercises to improve tendon strength, flexibility, and foot stability

In moderate to severe cases, you may need a moon boot (CAM walker) for short-term immobilisation to allow the tendon to heal.

What Happens If Posterior Tibial Tendinopathy Is Left Untreated?

Delaying treatment can lead to:

  • Progressive collapse of the foot arch

  • Development of adult-acquired flatfoot

  • Worsening ankle instability

  • Chronic pain and loss of function

  • Altered gait leading to secondary issues in the knees, hips or lower back

  • Permanent tendon damage, possibly requiring surgery

Prevention Tips

Once your condition is managed, our podiatrists will help guide you through long-term prevention strategies, including:

  • Wearing supportive footwear with strong arch control

  • Continuing with your strengthening and mobility exercises

  • Avoiding barefoot walking, especially on hard surfaces

  • Replacing worn-out shoes regularly

  • Using orthotics as recommended for arch support and stability

  • Gradually increasing activity levels to avoid tendon overload

Why Choose KL Foot Specialist Podiatry?

Our team is highly experienced in managing tendon-related injuries using advanced podiatric therapies and a patient-centred approach. From early-stage tendinopathy to chronic and complex cases, we offer complete foot and ankle care under one roof in Kuala Lumpur.

Book an Appointment Today

If you’re experiencing pain on the inside of your ankle or think you may have posterior tibial tendinopathy, don’t delay. Early diagnosis and expert care are essential. Let our experienced podiatrists help you get back to living, walking and moving without pain.