Overview
Posterior tibial tendinopathy is an overload pattern affecting the tendon that runs behind the inner ankle and supports the arch. It usually develops gradually and can make longer walks, hills, running or repeated single-leg push-off uncomfortable.
Typical Pattern
- Tenderness behind or just below the inner ankle bone
- Arch or inner-foot fatigue with longer standing and walking
- Symptoms with hills, running or repeated heel raises
- A gradual pattern rather than a single traumatic pop
What Usually Helps
Start by reducing the running, hill or standing dose that reliably flares symptoms, while maintaining comfortable activity. Then build calf, foot and single-leg capacity progressively. Footwear or temporary support can sometimes make activity more comfortable, but it does not replace rebuilding tendon capacity.
When to Get Assessed
Seek assessment if you notice a clear change in foot shape, worsening inability to perform a controlled single-leg heel raise, marked swelling, numbness in the sole, or pain that continues to worsen despite reducing load.
Related Guidance
This is general education, not a diagnosis. Inner-ankle and arch pain can come from tendon, nerve, joint or bone structures.