The tibialis posterior is a muscle in the back of the lower leg. Trigger points cause pain in the ankle, heel, bottom of the foot, and will sometimes extend up into the back of the calf. TrPs will also contribute to weak ankles that collapse inward.

Contents of Article

    Where Is The Tibialis Posterior Muscle?

    Tibialis Posterior Muscle Showing Trigger Point Location

    The tibialis posterior lies between and connects the two lower leg bones, the tibia and the fibula. The muscle continues down the leg, wraps around the heel (calcaneus) via a tendon, and connects to several bones in the middle of the foot.

    What Movements Does It Control?

    • Twists the foot inward
    • Bends the foot downward
    • Assists with standing on your toes
    • Assists with pointing your toes

    For detailed anatomy information:  Tibialis Posterior Anatomy


    Tibialis Posterior Muscles Trigger Points Symptoms:

    Tibialis Posterior Referred Pain Pattern
    • Pain in the back of the lower leg, just above the heel
    • Pain can go into the heel and down into the bottom of the foot
    • Pain will sometimes radiate high into the calf
    • Ankles tend to collapse inward

    TWD Recommends

    Neo G Medical Grade VCS Calf Support/Shin Splint provides support and warmth to the lower leg muscles. This brace is recommended for Achilles tendon strain or sprain and strains, sprains, and overuse injuries of the lower leg muscles. An excellent choice for compression and support of the tibialis posterior. If you suspect or have ever been diagnosed with blood clots, consult your doctor before using this brace.

    What Causes Tibialis Posterior Trigger Points To Develop?

    • Running or walking on uneven ground.
    • Walking with your foot turned inward (pigeon-toed)
    • A tendency to walk on the inside of the foot
    • Worn shoes that allow the foot to fall to the inside

    TWD Recommends

    Sore shins or calves? Feel as if shin splints are coming on? The ProStretch Calf Stretcher & Foot Rocker can help! The stretcher/rocker stretches and helps to relax most of the muscles in the lower leg and foot. Used by physical therapists to treat sore shins and calves as well as foot pain and plantar fasciitis.

    Tibialis Posterior Trigger Point Treatment

    The first option for treatment is to find a massage therapist, chiropractor, or physical therapist who knows trigger point therapy. They will show you how to find the muscle, the trigger point and show you how to treat the TrP.

    The second is to learn how to do self-treatment.  The Trigger Point Therapy Workbook is the resource to treat trigger point muscle pain throughout the body. The workbook includes diagrams and instructions on locating trigger points in each muscle and the method to treat those specific trigger points.

    Trigger points in the tibialis posterior need several 1-2 minute treatments spread throughout the day for optimal outcomes. Continue treatment until pain and symptoms no longer occur when pressure is applied to the area.

    Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice for pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. If you have reoccurring leg or foot cramps you should keep Somba on hand, it provides almost instant relief. (Not sold in stores)

    Biofreeze Pain Relieving Gel is an excellent pain-relieving gel recommend for those who have sudden onset muscle pain or recent injuries.  It is better to use than warm therapy gels and creams for muscle pain caused by inflammation as it cools the area much like ice. If your pain is from a recent injury, use Biofreeze. It is excellent to use on sprains, strained and sore ankles.

    Interesting facts:

    • Dysfunction in the tibialis posterior can cause you to turn your foot in and or walk on the inside of your foot.
    • Pain from trigger points in the tibialis posterior is sometimes diagnosed as Achilles tendinitis (this is called over-pronation)
    • Toning shoes stress the tibialis posterior. The shoes change the normal walking and running gait to a rocking motion known to stress the tibialis posterior.
    • Symptoms of the tibialis posterior are often diagnosed as fallen arches because the ankle(s) collapse inward.

    Tibialis posterior muscle pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

    • Posteriomedial shin splints
    • Deep posterior compartment syndrome
    • Tibialis posterior tendon dysfunction
    • Tarsal tunnel syndrome
    • Hammer or claw toes
    • Plantar fasciitis
    • Plantar wart
    • Gout
    • Sprain/strain of the ankle
    • Peripheral vascular disease (PVD)
    • Deep Vascular Thrombosis (DVT)
    • Ruptured Achilles tendon
    • Achilles tendinitis
    • Calcaneal spur syndrome


    Other muscles that should be considered and examined:

    Satellite trigger points associated with the tibialis posterior muscle:

    If you find TrPs in the tibialis posterior, check these muscles for additional trigger points:

    • Flexor Digitorum Longus
    • Flexor Hallucis Longus
    • Peroneus Longus
    • Peroneus Brevis
    • Peroneus Tertius

    TWD Recommends

    Lower Leg Compression Sleeves are used by many athletes. Compression sleeves provide compression, support, and warmth without adding bulk to the lower leg muscles. Athletic trainers recommend sleeves for shin splint, strained calf muscles, and overuse injuries of the lower leg muscles. Sleeves are also great as a preventative measure against shin splints and tired sore calf muscles after sports activities. Compression sleeves are also shown to reduce recovery time after strenuous activities and injury.

    Note: If you suspect or have ever been diagnosed with blood clots, consult your doctor before using compression sleeves or braces.

    Muscles With Similar Pain Patterns

    Soleus Muscle
    Gastrocnemius Muscle