Is Your Footwear Causing Posterior Tibial Tendonitis? Signs to Watch For

Foot pain can make walking, exercising, and even everyday activities uncomfortable. One common cause of pain along the inside of the foot and ankle is posterior tibial tendonitis, a condition that develops when the posterior tibial tendon becomes inflamed or irritated.

At Renew Foot & Ankle in Minnesota, Eric Gilbertson, DPM, FACFAS, helps patients identify the underlying causes of foot and ankle pain, including posterior tibial tendonitis. In many cases, footwear plays a larger role than people realize.

If you're experiencing foot pain, your shoes may be contributing to the problem. Here are some signs to watch for.

What is posterior tibial tendonitis?

The posterior tibial tendon connects a calf muscle to the bones on the inside of your foot. This tendon plays an important role in supporting your arch and stabilizing your foot while walking.

When the tendon becomes overworked or strained, inflammation can develop. Over time, untreated tendonitis may weaken the tendon and contribute to arch flattening.

How footwear can contribute

Your shoes affect how force is distributed throughout your feet with every step.

Footwear that lacks adequate support can place additional strain on the posterior tibial tendon. Over time, this repeated stress may increase inflammation and worsen symptoms.

Common footwear concerns include:

• Worn-out athletic shoes
• Flip-flops
• Flat shoes with little arch support
• Unsupportive sandals
• Shoes that no longer fit properly

While footwear may not be the only cause of posterior tibial tendonitis, it can significantly contribute to the condition.

Sign #1: Pain along the inside of your ankle

One of the earliest signs of posterior tibial tendonitis is pain along the inside portion of the ankle.

You may notice discomfort during walking, exercise, or prolonged standing. The pain often develops gradually and becomes more noticeable with activity.

If your shoes fail to support your arch properly, the tendon may experience additional strain throughout the day.

Sign #2: Swelling near the tendon

Inflammation often causes swelling along the inside of the ankle or foot.

You may notice tenderness when touching the area or feel discomfort while wearing certain shoes. Swelling can become more pronounced after physical activity or prolonged standing.

Sign #3: Your arch appears flatter

As the posterior tibial tendon weakens, it may become less effective at supporting your arch.

Some people notice that one foot appears flatter than the other or that their shoes wear unevenly. Changes in foot shape should not be ignored, as they may indicate progression of the condition.

Sign #4: Foot fatigue develops quickly

If your feet feel unusually tired after walking or standing, inadequate support may be forcing the posterior tibial tendon to work harder than normal.

Many patients describe aching or fatigue along the arch and inside of the foot after activities that previously caused no problems.

Sign #5: Pain worsens in unsupportive shoes

Pay attention to when your symptoms occur.

If your pain consistently worsens while wearing flip-flops, flat shoes, worn sneakers, or unsupportive footwear, your shoes may be contributing to the problem. Many patients notice improvement when they switch to more supportive options.

Sign #6: Difficulty with physical activity

Posterior tibial tendonitis can make exercise increasingly difficult.

Walking long distances, running, climbing stairs, or participating in sports may aggravate symptoms. As the condition progresses, even routine daily activities can become uncomfortable.

When to seek treatment

Early treatment often helps prevent further tendon damage and reduces the risk of long-term complications.

Treatment may include:

• Supportive footwear recommendations
• Custom orthotics
• Activity modification
• Physical therapy
• Anti-inflammatory treatments
• Bracing or immobilization when necessary

Ignoring symptoms can allow the condition to worsen and may increase the likelihood of developing adult-acquired flatfoot deformity.

If you're experiencing persistent pain along the inside of your foot or ankle, call Dr. Gilbertson or schedule an evaluation online. Identifying the cause early can help protect your foot function and get you back to your normal activities with greater comfort.