Inner ankle pain and flat foot: physiotherapy in Amman

What is the posterior tibial tendon?

It is a tendon that runs behind the inner ankle bone and along the inside of the foot, acting like a strap that holds up the arch and steadies the foot as you walk. When it is overloaded or weakens, pain appears inside the ankle, and over time the arch may drop and the heel may tilt outwards. Not every pain on the inside of the ankle is a simple sprain; this tendon is a common cause that is sometimes missed.

Common signs and risk factors

• Pain or swelling inside the ankle and along the arch, worse with walking, long standing or running
• The arch seems to be dropping, and from behind the heel may look tilted outwards
• Difficulty rising onto your toes on one foot or lifting the heel
• More common in women over 40 and in people with excess weight, diabetes or high blood pressure
• It may follow a sudden increase in walking, standing or sport, or an earlier ankle injury

Common misunderstandings

• "It is a minor sprain and will go away on its own": if inner ankle pain lasts and the arch drops, it is worth checking the tendon
• "I must have an MRI": it is requested if a tear is suspected or there is no improvement, but diagnosis starts with a clinical examination
• "Surgery is the only answer": in the early stages many cases improve without surgery, and the surgical decision belongs to the specialist doctor

What usually helps?

The plan is to load the tendon gradually rather than rest for a long time. Types of exercise that usually help include heel raises, first seated and then standing; turning the foot inwards against an elastic band; and balance exercises on one leg. We start with what the tendon tolerates without increasing pain, then add load and repetitions slowly. A firm, supportive shoe and temporarily cutting down long standing or walking also help. A doctor may recommend a brace or an insole in some cases, and that is the doctor’s decision. If the condition does not improve or the deformity increases, the specialist doctor decides whether anything else is needed.

How we treat it at Revibe

• We listen: when the pain started, what makes it worse, your work and the shoes you wear
• We examine the ankle, foot and arch, tendon strength, walking and balance
• We identify what keeps the tendon overloaded
• We treat: manual therapy for the foot and ankle joints, release of muscle knots in the calf, and dry needling or cupping when useful as part of the plan
• We progress with a home exercise programme that increases load gradually and adjust it to your response

Watch the explanation

FAQ

More common questions: Foot and ankle questions — 27 questions

Related pages

Reviewed by Ahmed AlKhatib, licensed physiotherapist — 22 October 2026

This information is general education and does not replace a clinical assessment.