Flat Feet & Posterior Tibial Tendonitis
The 4 Stage Treatment Guide!
Posterior Tibial Tendonitis Treatment:
Do you have flat feet?
- We go over the 4 stages of flat foot & posterior tibial tendonitis pain!
- These are The BEST & Most PROVEN Treatment Options!
- We go over the most common causes of flat foot & fallen arches.
What is Posterior Tibial Tendonitis?
- The posterior tibial tendon is responsible for your flat foot pain collapsed arches.
- We then go over the best insoles for flat feet and orthotics for flat feet.
- We show specifically why you need arch support for flat feet and how this relieves your posterior tibial tendonitis pain.
4 Stages of Adult Acquired Flat Foot:
The 4 stages of flat foot are roughly: Watch the video to diagnose which stage you are!
1.Posterior tibial tendonitis with flat foot.
2. Posterior tibial tendonitis with flat foot and arch collapse.
3. Posterior tibial tendon tear with arch collapse and foot arthritis.
4. Posterior tibial tendon destruction and ankle tendonitis and ankle collapse.
There are specific treatments for each stage of flat foot. We go over the best ones with you and get your feeling better as soon as possible!
Posterior Tibial Tendonitis Treatment:
- There are usually two phases to bottom of the foot pain treatment.
- The two phases of treatment include controlling the acute inflammation, and correcting the biomechanics which led to the problem in the first place.
- If the tendons and ligaments are inflammed, they are almost frozen in place and cannot function properly.
- Once the inflammation is decreased, we need to correct the biomechanical causes to ensure that they can never become over worked and inflammed again!
- This doesn’t matter whether it’s plantar fasciitis, plantar fibroma, sore bottom of foot, or even Achilles tendon pain. Treatment is all roughly very similar.
Control Inflammation:
Massage & Ice Products:
- Ice is the an excellent option that can be safe for almost everyone.
- There is some debate whether icing is worth doing, but for chronic pain this can help limit the need for medications and keep your options open.
- This works great for your arch, less for the ball of the foot.
- The more muscle and ligament tissue there is, the better ice will work there.






Menthol Based Gels:
- Biofreeze is one of our favorites.
- These gels have been studied to work 2x as long as ice.
- This works great for the ball of the foot.
- This can be very effective for bottom of the heel and Achilles tendon sore regions.








Massage Sticks:
- These can work great for loosening your muscles.
- This allows less tightness and pressure on the ball of your foot.
- This is very effective for the arch, the gastrocnemius or calf muscle and for the hamstring and thigh muscles.
- This also works very well for the gluteus muscles if you are having butt cheek or hip pain.






Removing The Stress:
- The key is to prevent future pain.
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- The best way to ensure that your plantar fascia, foot and ankle ligaments are not overworked is to support them.
- The best way to support them is to use great orthotics and great shoes.
- Some people may also need to rely on supportive ankle braces and other supportive modalities.
Get Great Shoes:
- Getting a great supportive pair of shoes will make sure that there is pressure removed from the heel and plantar fascia region.
- This is especially important if you have plantar fasciitis, heel spur pain or Achilles tendonitis.
- Consider shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
Get Great Orthotics:
- These are our recommended orthotics.
- There are different types for different shoes.
- Women’s shoes usually need a less bulky orthotic, but allow for less correction.
- A full length orthotic requires a running shoe, boot or comfortable walking/dress shoe.
- We recommend doing everything you can to get a good supportive shoe that can fit a full length orthotic.
- This is the best way to maximize your orthotics for great results.
Best Full Length Orthotics:
- These will only work in wider shoes or a good supportive running shoe.
- This will not work in sandals, flats or most women’s dress shoes.








Best Dress Shoe Orthotics:
- These are a great choice for dress orthotics.






Best 3/4 Length Orthotics:
- These are great options for women’s dress shoes and thinner shoes.
- These are not the most supportive pair of orthotics.


Get A Great Dynamic Stretch:
- It is possible to stretch on your own, but these products can also really help!
- This will take pressure off of the ball of your foot.
- We personally prefer this method of stretching.








Get A Great Static Stretch:
- These devices are great for stretching while you are resting.
- This will also help take pressure off of the ball of your foot.
- This works great for plantar fasciitis.
- It can be used while watching TV or at night time.






Walk This Way: Trusted Foot & Ankle Information
Learn what’s hurting and how to fix it.
Why Choose Balance Foot & Ankle Specialist in Howell and Bloomfield Hills?
Our experienced podiatric surgeons combine precision, care, and innovation to deliver successful outcomes in flatfoot reconstruction. With modern facilities, patient education, and compassionate care, we’ve become the trusted choice for foot and ankle surgery in Southeast Michigan. We’re committed to restoring your stride—comfortably and confidently.

FAQ: Posterior Tibial Tendonitis – Causes, Symptoms, and Treatment Options
Posterior tibial tendonitis is an inflammation or injury to the posterior tibial tendon, which runs along the inside of your ankle and foot. It plays a key role in supporting the arch and stabilizing the foot during walking.
The condition is commonly caused by overuse, especially in athletes or those who engage in repetitive activities like running, walking, or jumping. Other factors include flat feet, high arches, improper footwear, or previous injuries.
Symptoms typically include pain along the inside of the ankle and foot, swelling, difficulty standing or walking for long periods, a feeling of instability, and tenderness along the tendon. The pain may worsen with activity.
Your doctor will perform a physical exam and likely order imaging tests such as an X-ray or MRI to determine the location and severity of the fracture.
Initial treatments usually include rest, ice, anti-inflammatory medications, and physical therapy to strengthen the tendon. Orthotic insoles, braces, and supportive footwear are often recommended to relieve pressure on the tendon.
Surgery is typically considered when conservative treatments fail, especially if the tendon is severely damaged or the foot’s arch collapses. Surgical options can include tendon repair, reconstruction, or in some cases, a fusion of the affected joint.
Recovery time can vary. Mild to moderate cases usually improve within 6 to 8 weeks with proper treatment. However, more severe cases or those requiring surgery may take several months for full recovery.