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Posterior Tibialis Tendonitis vs. Plantar Fasciitis

Do the arches of your feet seem to be collapsing or falling?


Weakness of the posterior tibialis tendon could be the culprit. Many cases of fallen arches begin with dysfunction of the posterior tibial tendon.


When the tendon becomes weakened or torn, it is unable to provide stability and support for the arch of the foot, resulting in falling arches and arch pain.

In this article, I will share the best way to determine if your arch/foot pain is posterior tibial tendon disorder or plantar fasciitis.


Dr. Angela Walk

The Plantar Fasciitis Doc

Teaching you to resolve plantar fasciitis at home

Is Your Arch Pain Posterior Tibialis Tendon Disorder (PTTD) or Plantar Fasciitis?


These two diagnoses present with many of the same symptoms and have many similarities. Although there is some overlap between these two diagnoses, there are several important differences.


What Is The Posterior Tibialis Tendon?


The posterior tibialis tendon (PTT) originates at your lower leg and wraps under the arch of your foot.


It's main function is to control pronation as we walk and run and helps keep that arch elevated.


The primary cause of a weakness and increased stress on the PTT is excessive overpronation. This is most likely due to loss of calf muscle flexibility and limited ankle dorsiflexion.


Repeated foot overpronation (arch dropping) produces tendinitis along the medial malleolus and toward the insertion on the arch.


Because of its location on the bottom of the foot, many people misdiagnose this condition as plantar fasciitis. The arch becomes very painful to the touch.


Posterior Tibialis Tendon Disorder (PTTD) can also be causes by overuse and result in a tear. People who participate in high-impact sports, such as basketball, tennis, or soccer, may have tears of the tendon from repetitive use.


Symptoms Of Posterior Tiabialis Tendon Disorder vs. Plantar Fasciitis


The pain from PTTD is often higher up along the inside aspect of the foot and ankle whereas PF often presents more along the bottom surface of the foot, usually closer to the heel.


A hallmark sign of PTTD is decreased endurance and strength when performing single-leg heel raises.  Being able to stand on one leg and come up on "tiptoes" requires a healthy posterior tibial tendon.


You also may notice instability while walking or an impaired ability to stand on your toes.


The hallmark sign of PF is pain with the first few steps in the morning or after a period of prolonged sitting, although this can be present with PTTD.  


Treatment Of Posterior Tiabialis Tendon Disorder vs. Plantar Fasciitis


Both of these conditions result from a too much load on the foot. In either case, the treatment plan is very similar. You must strengthen the intrinsic foot muscles and PTT with progressive loading.


Progressive loading is defined as the gradual increase of resistance during an exercise set which results in improved strength and muscle development over time.



  1. Calf Raises With A Ball Between Your Heels: Performing this exercises helps to strengthen the posterior tibialis muscle. Squeezing the ball activates the PTT. 1-2 sets of 12-15 reps.


  1. Calf Raises On A Slant Board: Progressing to performing the calf raises with a ball on a slant board increases the load and further increases strength. 1-2 sets of 12-15 reps.


  1. Single Leg Calf Raises: The PTT responds to progressive loading and this is the next step in increasing tension on the tendon. 1-2 sets of 12-15 reps.


  1. Perform Fascial Release Technique: Use the fascial tool to address fascial adhesions and scar tissue accumulation in the PTT. This is the preferred type of soft tissue mobilization to improve tissue quality and promote healing


  1. Wear Toe Spacers: Toe spacers help to broaden the base of the foot and prevents overpronation. This decreases the load on the PTT.

Can I Treat Plantar Fasciitis At Home?

I specialize in foot and gait mechanics, and I have seen thousands of cases of plantar fasciitis. If you have this debilitating condition, here are my top 2 recommendations.

  1. Download my free guide. This is the first step on your PF recovery journey. I show you the exact steps to resolve plantar fasciitis at home.

  2. Follow my social media pages. I offer daily tips, exercises, and the latest insights on PF. You can also connect and learn from others with the same struggles. Join us: Facebook page & Instagram  

Because there is a so much misinformation out there about plantar fasciitis, I spend most of my time educating people on what NOT to do.

Most rehabilitation efforts fail because they are relying on cortisone shots, night splints, orthotics, ineffective stretching, thick, cushiony shoes, and rolling on a frozen water bottle.

These methods are either ineffective or just short-term band-aids, and do not provide long-term correction.

In my (6) step free guide, I offer solutions through addressing multiple factors. Improving footwear, identifying areas of weakness in the foot and ankle, and restoring proper foot function.


Wishing you health & happiness,

Dr. Angela

The Plantar Fasciitis Doc

I've written extensively on the topic of Plantar Fasciitis. Take a look at these other related blog posts:


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