Posterior tibial tendonitis: inner ankle pain and a flattening arch
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Short answer
The posterior tibial tendon runs behind the inner ankle bone and holds up your arch. When it's inflamed or wearing out, you get pain and swelling along the inside of the ankle, then gradual arch collapse. It's the most common cause of flatfoot that develops in adults, and it usually worsens without early treatment, so get it assessed rather than self-treating. Stable shoes are sensible comfort footwear in the meantime.
Symptoms
- Pain and swelling along the inside of the ankle and arch.
- Weakness when pushing off.
- Over time, the arch flattens, the toes point outward and the ankle rolls in; pain may shift to the outside of the foot.
Causes and risk factors
Cleveland Clinic and ACFAS list overuse (running, walking, hiking, stairs), existing flat feet or high arches, prior injury, extra weight and inflammatory arthritis.
Treatment
Early care improves outcomes. Clinicians use rest, ice, anti-inflammatories, physical therapy, custom orthotics or ankle braces, supportive shoes, and sometimes a boot or cast for several weeks. Cleveland Clinic says acute tendonitis may heal within weeks; chronic cases take three to four months of conservative treatment.
Illustration Motion-control walking shoe
Brooks Addiction Walker 2
A firm, motion-control leather walking shoe. Heavy, but very stable, which many people with flat feet find comfortable.
- Leather walking shoe
- Motion-control rollbar
- 12 mm drop
- Widths B to 4E
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Illustration Stability shoe
Brooks Adrenaline GTS 25
A stability shoe that guides the foot and knee instead of blocking motion. It suits flexible flat feet and people whose arches collapse as they walk.
- Stability (GuideRails)
- 10 mm listed drop
- Narrow to extra-wide
- APMA Seal of Acceptance
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Illustration Stable and wide
New Balance 928v3 Walking Shoe
A stable, roomy walking shoe with an unusual range of widths. The removable footbed makes room for custom orthotics.
- Leather walking shoe
- Rollbar stability
- Widths up to 6E (men's)
- Removable footbed
See today's priceAmazon prices change often Check price at Amazon
- You have pain and swelling along the inner ankle that isn't settling.
- Your arch is visibly flattening or your foot is turning outward.
- You notice new weakness when pushing off with that foot.
Common questions
Is posterior tibial tendonitis serious?
It can be. ACFAS notes it usually gets worse without early treatment and is the most common cause of adult-acquired flatfoot. Early care keeps it from progressing.