Understanding the Tibialis Posterior: Why It Matters, Common Injuries, and How to Support It

The tibialis posterior is one of the most important but often overlooked muscles in the lower leg. Located deep in the calf, this muscle runs along the inside of your shin, wrapping behind the medial ankle and attaching into the midfoot.

Its key roles are:

• Supporting the medial arch of the foot

• Controlling pronation (preventing the arch from collapsing)

• Assisting plantarflexion and inversion of the foot

When functioning well, the tibialis posterior provides essential stability for running, walking, and multidirectional sports. But when it becomes weak, fatigued, or overloaded, it can contribute to several painful conditions.

Conditions Linked to Tibialis Posterior Dysfunction

1. Posterior Tibial Tendon Dysfunction (PTTD)

   
   

   A progressive condition where the tendon loses its ability to support the arch, often leading to adult-acquired flat foot.

   
   

2. Shin Splints (Medial Tibial Stress Syndrome)

   
   

   Excessive load through the tibialis posterior can irritate the muscle and periosteum along the shin.

   
   

3. Plantar Fasciitis and Heel Pain

   
   

   Weakness of the tibialis posterior places more demand on the plantar fascia, leading to irritation.

   
   

4. Ankle Instability

   
   

   Poor tibialis posterior control can allow excessive foot pronation, contributing to recurrent sprains.

   
   

5. Stress Fractures

   
   

   Altered foot mechanics from tibialis posterior weakness can increase bone loading in the tibia, navicular, or metatarsals.

Strengthening the Tibialis Posterior

Strengthening is the cornerstone of long-term recovery and injury prevention. Evidence suggests that targeted strengthening improves tendon load tolerance and reduces risk of progression in conditions like PTTD.

Here are three effective tibialis posterior exercises:

1. Theraband Inversions

   
   

   Anchor a resistance band and pull the foot inward against resistance.

   
   

2. Heel Raises with Arch Focus

   
   

   Perform calf raises while focusing on lifting the arch and avoiding excessive pronation.

   
   

3. Single-Leg Balance with Arch Control

   
   

   • Stand on one leg and maintain arch support while performing small knee bends or reaching movements.

     
     

Start with 2–3 sets of 10–15 reps, progressing load gradually over time.

Offloading the Tibialis Posterior with Taping

While strengthening provides long-term benefits, taping can help offload the tibialis posterior in the short term, especially in athletes returning to running or sport.

We’ve created a video demonstrating two approaches:

Taping not only reduces load but also offers proprioceptive feedback, improving confidence in movement.

Final Thoughts

The tibialis posterior plays a vital role in lower limb stability and performance. Weakness or dysfunction can contribute to issues ranging from shin splints and heel pain to flat feet and ankle injuries.

• Strengthening builds long-term resilience.

• Taping offers short-term support, particularly during sport or high load.

• Early intervention is key to preventing progression to more severe conditions like PTTD.

At Body Fit Physiotherapy in North Adelaide, we combine hands-on treatment, exercise prescription, and supportive techniques such as taping to help you return to pain-free activity and prevent future injuries.

✅ Need help with persistent foot or shin pain? Book a consultation with our team today to start your recovery.