A nagging ache along the inside of your ankle or arch might be more than just a sore foot — it could be a warning sign that one of the most important tendons in your lower leg is in trouble. Left untreated, posterior tibial tendonitis can quietly progress into a flatter foot, weaker arch, and chronic pain that limits the activities you love. The good news is that early, targeted care can calm inflammation, protect your arch, and get you back on your feet with confidence.
At Sweeney Foot & Ankle Specialists, Dr. D. Sean Sweeney, DPM, FACFAS, and Dr. Christy Leahey, DPM, FACFAS, bring more than 20 years of trusted experience to every diagnosis. Voted Best Podiatrist in The Woodlands by Living Magazine every year since 2012, our team blends advanced technology with personalized, compassionate treatment for sports injuries.
What Is Posterior Tibial Tendonitis?
The posterior tibial tendon runs from deep in the calf, behind the bony bump on the inside of your ankle, and attaches to several spots along the bottom of your arch. With every step, it helps lift, support, and restore your foot’s arch. When that tendon becomes irritated or inflamed, the result is posterior tibial tendonitis — a common precursor to a more serious condition called posterior tibial tendon dysfunction, which involves progressive arch collapse and tendon weakening.
This condition isn’t limited to people with flat feet. Patients with high arches, average arches, and a wide range of activity levels can all develop it.
Symptoms to Watch For
- Pain and swelling along the inside of the ankle or arch
- Discomfort that worsens with walking, standing, or exercise
- A feeling of weakness when pushing off the foot
- Difficulty rising onto your toes on the affected side
- Pain that lingers even at rest in more advanced cases
Swelling along the tendon often reflects excess lubricating fluid the body produces while trying to heal. In advanced cases, untreated tendonitis can progress to partial or complete tendon tears.
How Posterior Tibial Tendonitis Is Diagnosed
Diagnosis usually begins with a detailed history and hands-on physical exam. A simple in-office test — standing on the “tip of the toes” on each foot — can reveal weakness on the affected side. When more detail is needed, an MRI or ultrasound may be ordered to evaluate the extent of tendon damage and guide your treatment plan.
Treatment Options
Treatment is tailored to the duration of symptoms and the extent of tendon strength loss. Conservative care is usually the starting point and often includes:
- Anti-inflammatory medications
- Rest and activity modification
- Custom orthotics to support the arch and offload the tendon
- In-office physical therapy to rebuild strength and flexibility
- MLS laser therapy to reduce pain and inflammation while accelerating tissue repair
- Cast immobilization for four to six weeks in more severe cases
If conservative care doesn’t deliver the relief you need, surgical options to clean and repair the tendon may be recommended — particularly when progressive weakness points toward posterior tibial tendon dysfunction.
Why Choose Sweeney Foot & Ankle Specialists for Posterior Tibial Tendonitis in The Woodlands, TX?
For more than two decades, families across The Woodlands, Magnolia, and Greater Houston have trusted Sweeney Foot & Ankle Specialists for personalized, technology-forward podiatric care. Our team takes the time to understand how your symptoms affect your daily life, then builds a treatment plan that respects your goals — whether that’s returning to running, keeping up with your kids, or simply standing through a workday without pain. Combined with prompt appointments for urgent foot and ankle concerns, we provide podiatric care that feels both leading-edge and refreshingly approachable.
Take the Next Step Toward Lasting Relief
Posterior tibial tendonitis rarely improves on its own, but with the right care, it’s a very treatable condition. Early diagnosis, supportive treatments, and expert guidance can protect your arch, ease your pain, and help you stay active for the long haul.
Schedule your consultation with Sweeney Foot & Ankle Specialists today — call our office in The Woodlands at (281) 292-4944 or our Magnolia location at (281) 789-4956 to get started on your path back to comfortable, confident movement.