Posterior Tibial Tendonitis

Quick answer: Posterior Tibial Tendonitis 2 comes up often in our clinics. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Call (810) 206-1402.

✅ Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

Posterior Tibial Tendonitis Treatment [Inside of the Ankle Pain]

Do you have posterior tibial tendonitis? We go over the #1 posterior tibial tendonitis treatments for inside of the ankle pain!

Look:

• We show you a detailed comprehensive treatment video on posterior tibial tendonitis.
• We will show you heel pain and inside of the ankle pain photos and causes.
• And we will show you the best treatment products for you posterior tibial tendonitis pain!

So WATCH the VIDEO!

https://youtu.be/6rS6f7Z3S7A

Posterior Tibial Tendonitis Treatment [Inside of the Ankle Pain] Overview:

• Do you have posterior tibial tendonitis? This is also known as inside of the ankle pain!
• We go over the absolute best inside of the ankle and inside of the foot pain treatment as well as posterior tibial tendonitis treatments!
• Posterior tibial tendon dysfunction or the tibialis posterior is one of the most common causes of pain on inside of foot or inside of the ankle pain!
• So lets start on your posterior tibial tendonitis treatment!

 

Expert Foot Pain Care in Michigan: Diagnosis and Treatment at Balance Foot & Ankle

Michigan patients with any foot pain condition — whether it is clearly diagnosed or still uncertain despite prior medical visits — can receive expert podiatric evaluation at Balance Foot & Ankle. Our fellowship-trained podiatric surgeons use weight-bearing digital X-rays, musculoskeletal ultrasound, and detailed clinical examination to establish accurate diagnoses, and provide treatment options ranging from conservative management (custom orthotics, injection therapy, EPAT, physical therapy coordination) to surgical correction when structural problems require it. Both our Howell (4330 E Grand River, Livingston County) and Bloomfield Township (43494 Woodward Ave #208, Oakland County) offices offer same-week new patient appointments and in-office imaging. Michigan patients ready to address their foot pain definitively can call Balance Foot & Ankle at (810) 206-1402 to schedule.

Heel Spurs and Calcaneal Conditions in Michigan: Treatment at Balance Foot & Ankle

Michigan patients with heel spurs identified on X-ray should understand that the heel spur itself is rarely the direct cause of heel pain — the spur is a radiographic finding that often accompanies plantar fasciitis but does not cause symptoms independently. Pain is produced by the inflamed plantar fascia at its calcaneal insertion, not by the bony spur. This is clinically important because treatment targeting the plantar fascia inflammation is what produces pain relief, not treatment targeting the spur. At Balance Foot & Ankle, heel pain evaluation identifies the specific cause — plantar fasciitis, Baxter’s nerve entrapment, calcaneal stress fracture, or fat pad atrophy — and directs treatment accordingly. Custom orthotics with deep heel cups reduce plantar fascia load and distribute heel pressure away from the painful insertion; corticosteroid injection reduces acute inflammation; EPAT (extracorporeal pulse activation therapy) produces lasting resolution of recalcitrant plantar fasciitis. Michigan patients with heel pain or heel spurs can call Balance Foot & Ankle at (810) 206-1402 to schedule at our Howell or Bloomfield Township office.

Expert Foot Pain Care in Michigan: Diagnosis and Treatment at Balance Foot & Ankle

Michigan patients with any foot pain condition — whether it is clearly diagnosed or still uncertain despite prior medical visits — can receive expert podiatric evaluation at Balance Foot & Ankle. Our fellowship-trained podiatric surgeons use weight-bearing digital X-rays, musculoskeletal ultrasound, and detailed clinical examination to establish accurate diagnoses, and provide treatment options ranging from conservative management (custom orthotics, injection therapy, EPAT, physical therapy coordination) to surgical correction when structural problems require it. Both our Howell (4330 E Grand River, Livingston County) and Bloomfield Township (43494 Woodward Ave #208, Oakland County) offices offer same-week new patient appointments and in-office imaging. Michigan patients ready to address their foot pain definitively can call Balance Foot & Ankle at (810) 206-1402 to schedule.

Heel Spurs and Calcaneal Conditions in Michigan: Treatment at Balance Foot & Ankle

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Related Treatment Guides

• Plantar Fasciitis & Heel Pain Treatment
• Custom 3D Orthotics
• Foot & Ankle Arthritis Treatment

Michigan patients with heel spurs identified on X-ray should understand that the heel spur itself is rarely the direct cause of heel pain — the spur is a radiographic finding that often accompanies plantar fasciitis but does not cause symptoms independently. Pain is produced by the inflamed plantar fascia at its calcaneal insertion, not by the bony spur. This is clinically important because treatment targeting the plantar fascia inflammation is what produces pain relief, not treatment targeting the spur. At Balance Foot & Ankle, heel pain evaluation identifies the specific cause — plantar fasciitis, Baxter’s nerve entrapment, calcaneal stress fracture, or fat pad atrophy — and directs treatment accordingly. Custom orthotics with deep heel cups reduce plantar fascia load and distribute heel pressure away from the painful insertion; corticosteroid injection reduces acute inflammation; EPAT (extracorporeal pulse activation therapy) produces lasting resolution of recalcitrant plantar fasciitis. Michigan patients with heel pain or heel spurs can call Balance Foot & Ankle at (810) 206-1402 to schedule at our Howell or Bloomfield Township office.

Clinical References

1. Kohls-Gatzoulis J, Angel JC, Singh D, Haddad F, Livingstone J, Berry G. Tibialis posterior dysfunction: a common and treatable cause of adult acquired flatfoot. BMJ. 2004;329(7478):1328-1333.
2. Bluman EM, Title CI, Myerson MS. Posterior tibial tendon rupture: a refined classification system. Foot Ankle Clin. 2007;12(2):233-249.
3. Ross MH, Smith MD, Mellor R, Vicenzino B. Exercise for posterior tibial tendon dysfunction: a systematic review of randomised clinical trials and clinical guidelines. BMJ Open Sport Exerc Med. 2018;4(1):e000430.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your foot and ankle conditions, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

More questions patients ask

What are the stages of posterior tibial tendinitis?

Posterior tibial tendinitis (PTTD) progresses through four stages: Stage I — inflammation and mild pain without deformity; Stage II — flexible flatfoot deformity with arch collapse; Stage III — rigid flatfoot deformity; Stage IV — ankle arthritis added to flatfoot deformity. At Balance Foot & Ankle, early-stage PTTD responds very well to conservative treatment; advanced stages may require bracing or surgery.

What is the best brace for posterior tibial tendinitis?

For early-stage PTTD, a lace-up ankle brace with medial support provides sufficient stabilization. For Stage II PTTD with flatfoot deformity, a custom ankle-foot orthosis (AFO) or articulating AFO provides superior support by controlling subtalar joint motion and supporting the arch. Balance Foot & Ankle fits custom AFOs and recommends appropriate prefabricated braces based on deformity stage. Call (810) 206-1402 for evaluation.

How does overpronation cause posterior tibial tendinitis?

Overpronation creates excessive demand on the posterior tibial tendon, which must work harder to prevent arch collapse with every step. Over time, this repetitive overloading causes microtears, inflammation, and eventually tendon degeneration. Custom orthotics from Balance Foot & Ankle that control overpronation are the single most important conservative treatment for preventing PTTD progression.

Can posterior tibial tendinitis cause permanent flatfoot?

Yes, advanced posterior tibial tendon dysfunction (Stage II-III PTTD) results in progressive arch collapse and permanent flatfoot deformity as the tendon loses its ability to support the arch. This is why early treatment at Balance Foot & Ankle is crucial — once a rigid flatfoot develops, surgical reconstruction may be needed to restore alignment. Don't wait on inner ankle pain that is worsening with activity.

How is Stage II posterior tibial tendinitis treated?

Stage II PTTD treatment at Balance Foot & Ankle combines: custom orthotics or custom AFO to support the collapsed arch, structured physical therapy (eccentric heel raises, calf stretching), anti-inflammatory measures, and sometimes a walking boot for acute flares. Advanced Stage II cases unresponsive to 6 months of conservative care may require surgical reconstruction (calcaneal osteotomy, tendon transfer). Call (810) 206-1402.

Still have a question about coverage or cost? Book online and we will check your benefits before your visit: Book in Howell · Book in Bloomfield Township. Prefer to talk it through first? Call (810) 206-1402.