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Tibialis Posterior Muscle Calf and Foot Pain

The tibialis posterior is a muscle in the back of the lower leg that contributes to pain in the ankle, heel, and bottom of the foot. Pain will sometimes extend up into the back of the calf. If you have weak ankles that collapse inward, check the tibialis posterior for weakness and trigger points.

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    Where Is The Tibialis Posterior Muscle?

    Image showing the origin and insertion points of the tibialis posterior.

    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.

    Interesting Facts:

    • Dysfunction in the tibialis posterior can cause you to turn your foot in and walk on the inside of your foot.
    • Pain from trigger points in the tibialis posterior is sometimes diagnosed as Achilles tendinitis
    • Toning shoes change the normal heel-to-toe 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 flatting the arch of the foot (over-pronation of the ankle)

    What Does The Tibialis Posterior Muscle Do?

    Image demonstrating plantarflexion of the foot
      • Bends the foot downward (plantarflexion)
      • Twists the foot inward (inversion)
      • Assists with standing on your toes
      • Assists with pointing your toes

    For detailed anatomy information:  Tibialis Posterior Anatomy

    Tibialis Posterior Pain Symptoms


    The tibialis posterior pain centers in and around the Achilles tendon leading to the belief the tendon is strained. Pain may radiate into the calf, heel, and bottom of the foot. If you have been diagnosed with Achilles tendinitis, posterior compartment syndrome, or shin splints, check the tibialis posterior for muscle strain and trigger points.

    Signs and symptoms include:

    • 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

    Other muscles, including the tibialis posterior, contribute to these conditions

    Muscles With Similar Pain Patterns

    Gastrocnemius Muscle

    Soleus Muscle

    Recommended Muscle Pain Products

    Doctors and physical therapists often recommend using a TENS at home to relax muscles and ease the pain. The Belifu TENS Unit Muscle Stimulator is highly recommended and an excellent choice for treating upper and lower leg pain.

    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)

    What Causes Tibialis Posterior Muscle Pain?

    The tibialis posterior is affected by most foot and ankle injuries, especially those in which the ankle or foot turns inwardly when the injury occurs. Weak, unstable ankles and collapsed arches are primary sources of pain in the muscle.

    • 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

    Note: If you have injured the back, hip, leg, ankle, or foot, the tibialis posterior will likely develop trigger points.

    How To Avoid Development of Trigger Points In The Tibialis Posterior Muscle

    • Weak ankles and foot muscles contribute to lower leg pain—work at keeping these muscles strong and flexible.
    • Walking on the inside of your foot or with your toes turned in (pigeon-toed) will over-work the tibialis posterior muscle.
    • Worn-out shoes that allow your foot to turn in need to be replaced with supportive shoes that will keep your feet straight and balanced.
    • Walking on uneven ground is good exercise for the foot and lower leg muscles. Wearing the proper shoes and careful navigation, no slipping or sliding, will help keep the pain away.

    Tibialis Posterior Trigger Point Treatment


    The tibialis posterior is a deep muscle that lies under the other muscles of the lower leg. There are major nerves and blood vessels deep in the back of the calf that should not have sustained pressure applied, especially if you have nerve pain or circulatory problems.

    If you do not have experience treating trigger points, find a massage therapist, chiropractor, or physical therapist who knows trigger point therapy. They will show you how to find the muscle and the trigger point and treat the TrPs.

    You can also 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. If you carefully read and follow the treatment recommendations for the tibialis posterior, you can self-treat the 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.

    If you plan to self-treat, you will need one of these tools to treat the tibialis posterior. The easiest to use and most versatile tool is the Thera Cane Massager, which applies deep pressure and easily treats hard-to-reach muscles in the back, legs, and bottom of the feet.

    The Knobble is another tool that works well to apply precise deep pressure to a trigger point. It can be used on other muscles that you can easily reach.

    How Long Before I Feel A Reduction In Pain?

    Because the tibialis posterior muscle is deep it may take several treatments before you lasting relief. You may feel some relieve quickly, but most feel noticeable relief in several days. The key to trigger point therapy is consistency in doing your treatments. You must do the treatments regularly and continue until the trigger point is gone.

    Other muscles that should be considered and examined:

    Satellite trigger points associated with the soleus muscle:

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

    Products We Use and Recommend For Low Leg Muscle Pain

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


    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 relax most of the muscles in the lower leg and foot. Physical therapists use them to treat sore shins and calves as well as foot pain and plantar fasciitis.

    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.

    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