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Tibialis Posterior Muscle: Lower Leg, Heel and Foot Pain

Pain in the back of the lower leg right above the heel is the primary symptom of tibialis posterior dysfunction. The pain often travels down into the heel and bottom of the foot. Pain will sometimes extend up into the calf.

What are the pain and symptoms associated with the tibialis posterior muscle?

  • 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 collapse inward

Where is the tibialis posterior muscle located?

The tibialis posterior lies in between the tibia and fibula, the two bones of the lower leg. The muscle tendon wraps around the inside of the heel and attaches to several bones in the middle of the foot.

What movements does the tibialis posterior control?

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

Activities that cause tibialis posterior muscle pain and symptoms:

  • Running or walking on uneven ground
  • Tendency to walk on the inside of the foot
  • Worn shoes that allow the foot to fall to the inside


Tibialis Posterior Origin, Insertion, Action, Innervation

You use the rectus femoris when you straighten your knee and lift your bent knee up toward your torso.

Interesting facts about the tibialis posterior muscle:

  • 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 gait which is known to stress the tibialis posterior.
  • Symptoms of the tibialis posterior are often diagnosed as fallen arches because the ankle(s) collapse inward.

Clinical diagnoses to which the tibialis posterior muscle symptoms may contribute:

  • 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
  • L4 L5 S1 or S2 radiculopathy

Other muscles that should be considered and examined in conjunction with the tibialis posterior muscles:

Satellite trigger points associated with the tibialis posterior :

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

For detailed anatomy information:  Tibialis Posterior Anatomy

Help with Tibialis Posterior Muscle Pain

Cold Therapy Gel For Lower Leg, Ankle and Bottom Of The Foot Injury and Inflammation

Biofreeze Pain Relieving Gel is an excellent pain relieving gel and I recommend it 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. A recent study showed that Biofreeze decreased pain 2 times more than ice and the pain relief lasts 9 – 10 longer. To treat tibialis posterior muscle pain, rub BioFreeze into the calf, ankle and bottom of the foot.

Hot Cold Pack For Lower Leg Treatment

CorPak Soft Comfort Hot & Cold Pack Wrap is a versatile pack that can be used to treat the lower leg, foot / ankle, as well as other areas of the body. This pack works well for the tibialis posterior as it will cover the length of the calf and can then be used to wrap the foot for full treatment. The pack is filled with pliable gel and has a soft frost free cover that will not irritate your skin. For recent injuries, use it cold to reduce swelling. For older injures or chronic pain use heat to relax the muscles and increase circulation.

Warm Therapy Gel for Sore Lower Leg Muscles and Chronic Knee and Ankle Pain and Stiffness

Sombra Warm Therapy Pain Relieving Gel is a pain relieving gel that is highly recommended. It provides warmth without burning heat and is great for relieving pain. Applying Sombra to the muscles in the back of the leg continuing down around the heel and into the bottom of the foot can help reduce pain and tightness caused by the tibialis posterior muscle. I recommend Sombra for injury recovery, chronic pain, and arthritis pain and stiffness.

Lower Leg Compression Sleeves

Lower Leg Compression Sleeves are used by many athletes. Compression sleeves provide compression, support and warmth without adding bulk to the lower leg muscles. Sleeves are recommended by athletic trainers for shin splint, strained calf muscles and overuse injuries of the lower leg muscles. Sleeve 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.

Graduated Compression Socks for Support and Recovery

Eurosocks Over The Calf Compression Socks have become a go-to for both amateur and professional athletes for lower leg, ankle and foot injury recovery. Graduated compression helps relieve pain from muscle stiffness and soreness as well as discouraging inflammation. The socks wickable fabric keeps skin dry and DryStat technology inhibits the growth of odor causing microbes. The over the calf style works very well for tibialis posterior muscle recovery as the sock will cover the entire muscle. If you suspect or have been treated for blood clots, consult with a doctor before using compression on the lower legs.

Neoprene Calf/Shin Brace Splint

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 also strains, sprains and overuse injuries of the lower leg muscles. An excellent choice for tibialis posterior muscle support.  If you suspect or have ever been diagnosed with blood clots consult your doctor before using this brace.

Stretch The Calf and Foot Muscles To Relieve Flexor Digitorum Longus Foot Pain

Medi-Dyne Pro Stretch for Plantar Fascitis and Calf Pain is a device that provides a deep stretch to the foot and lower leg muscles. This device is used in many physical therapists offices and rehab facilities to those who have lower leg pain and cramps and for those who suffer from plantar fasciitis. When you first use the Pro Stretch be sure to start off slowly, 5 to 10 seconds per stretch, gradually building up reps and longer stretch times.

Note: If you suspect a torn Achilles tendon, consult a medical professional before use.

Self Treatment for Tibialis Posterior and Achilles Tendon Pain

Do you know that small  "knots" and other dysfunction in the tibialis posterior muscle can cause pain that mimics Achilles tendinitis or injury?

If you have unresolved Achilles, low leg, ankle, or bottom of the foot pain,  I  recommend that you purchase Claire Davies  The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. Mr. Davies explain the trigger point phenomenon and muscle pain in everyday language.  But what makes this book worth its weight in gold are the individual muscle trigger point treatments that Davies has compiled. His diagrams and step by step instructions help you locate which muscles are contributing to your pain, how to find the trigger point and treat it. If you suffer from unresolved lower leg, ankle, and foot pain I highly recommend this book. It takes time and practice to master finding trigger points, but once you learn you have a tool and method to help relieve muscle pain throughout the body. Relieving trigger points in the tibialis posterior muscles may help you resolve your leg, ankle, and foot pain issues. This book is a must-have for anyone interested in finding the cause and self-treating muscle pain.