Inner ankle and arch tendon pain ยท Starter home exercise plan

Posterior Tibial Tendon Pain Exercises

This progressive program is for clinician-evaluated pain of the tibialis posterior tendon along the inner ankle or arch, without a new rupture or progressive foot collapse. Supportive footwear or an orthosis may be an important companion to exercise.

Call 310-319-1234

Clinically reviewed August 28, 2026

Written and clinically reviewed by Jeremy Swisher, MD

Board-certified primary care sports medicine physician. Reviewed August 28, 2026.

View official UCLA profile (opens in a new tab)

Jeremy Swisher, MD

Evidence-informed home exercise program

Tibialis Posterior Tendinopathy Home Exercise Program

Name: __________________________________

Affected side: ______________

Start date: __________________

Review date: _________________

Clinician or PT: ______________________________

Before you start

This clinician-evaluated, early-stage starter plan is not a self-diagnosis tool and is not stand-alone treatment for progressive collapsing foot deformity. A new change in arch shape or heel alignment, inability to perform a single-leg heel raise, or increasing weakness should be assessed before exercise is advanced.

This program may fit

Load-related pain or tenderness behind the inner ankle bone and into the arch, often worse with prolonged walking, running, hills, stairs, or heel raises, with preserved or only mildly reduced push-off and no progressive deformity.

Get assessed first

Recent trauma or a pop, inability to perform a single-leg heel raise, clear loss of heel-rise height or endurance, new or increasing arch flattening, the heel drifting outward, the forefoot turning outward, rigid deformity, lateral ankle impingement pain, marked swelling, inability to walk normally, focal navicular bone tenderness, pain with hopping after a training increase, burning, numbness, or a hot swollen foot in diabetes or neuropathy.

Stop signs

Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Seek same-day urgent assessment for inability to bear weight after trauma, visible or rapidly progressive deformity, a hot red markedly swollen foot with or without fever, especially with diabetes or reduced sensation, a wound with spreading redness, or severe unrelenting pain. Arrange prompt evaluation for a pop with sudden loss of push-off, new arch collapse, inability to perform a heel raise, rapidly increasing weakness, focal navicular bone pain, new numbness, or progressive rest or night pain.

Check the next morning

Establish a repeatable daily step baseline. If walking is provocative, temporarily use cycling or swimming. Increase steps, pace, hills, or running one variable at a time while monitoring gait, push-off, swelling, and foot shape.

Fit and safety

Confirm this is the right diagnosis.

This clinician-evaluated, early-stage starter plan is not a self-diagnosis tool and is not stand-alone treatment for progressive collapsing foot deformity. A new change in arch shape or heel alignment, inability to perform a single-leg heel raise, or increasing weakness should be assessed before exercise is advanced.

This program may fit

Load-related pain or tenderness behind the inner ankle bone and into the arch, often worse with prolonged walking, running, hills, stairs, or heel raises, with preserved or only mildly reduced push-off and no progressive deformity.

Get assessed first

Recent trauma or a pop, inability to perform a single-leg heel raise, clear loss of heel-rise height or endurance, new or increasing arch flattening, the heel drifting outward, the forefoot turning outward, rigid deformity, lateral ankle impingement pain, marked swelling, inability to walk normally, focal navicular bone tenderness, pain with hopping after a training increase, burning, numbness, or a hot swollen foot in diabetes or neuropathy.

Do not self-start with these warning signs

Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Seek same-day urgent assessment for inability to bear weight after trauma, visible or rapidly progressive deformity, a hot red markedly swollen foot with or without fever, especially with diabetes or reduced sensation, a wound with spreading redness, or severe unrelenting pain. Arrange prompt evaluation for a pop with sudden loss of push-off, new arch collapse, inability to perform a heel raise, rapidly increasing weakness, focal navicular bone pain, new numbness, or progressive rest or night pain.

This is a diagnosis-specific home program, not a substitute for an examination. A clinician may change the exercise, dose, range, or timeline based on your history.

Your home program

Load the tendon while watching the shape and function of the foot.

The best exercise dose is uncertain. Small trials mainly studied strengthening together with foot orthoses and stretching, not exercise in isolation. A supportive shoe, arch support, brace, or temporary immobilization may be appropriate based on walking tolerance and deformity and should be individualized.

Frequency
Strength 2 to 3 nonconsecutive days per week; balance 2 to 3 days per week
Equipment
Resistance band, supportive shoe, stable support, optional small ball and weight
First checkpoint
Review the trend at 6 weeks; build for 8 to 12 weeks or longer
Primary goal
Restore push-off, walking, stairs, hills, and appropriate return to running
  1. Exercise 1

    Banded foot adduction

    2 to 3 days per week

    Dose3 to 4 sets of 12 to 15 repetitions

    Sit with both knees bent and the involved foot in a supportive shoe. Secure a band outside the forefoot at about 45 degrees to the floor. Keep the heel and leg quiet, slide the forefoot inward, then return over three seconds without clawing the toes.

    Make it easier

    Use no band, a shorter range, or four low-effort isometric holds of 20 seconds.

    Progress it

    Choose a stronger band or a four-second return after several stable next mornings. Keep the heel and leg still, and avoid increasing the challenge when medial ankle swelling or walking tolerance worsens.

    My starting dose or notes

  2. Exercise 2

    Heel raise with controlled heel direction

    2 to 3 days per week

    Dose3 sets of 8 to 15 repetitions

    Stand near a counter and keep pressure through the base of the big toe as you rise as high as controlled. Allow the heels to turn slightly toward each other, then lower over three seconds. A small ball between the heels can guide the motion; do not squeeze hard or force an arch position.

    Make it easier

    Use a seated or double-leg version with hand support.

    Progress it

    Progress to one leg, then add weight or use a stable step after 15 controlled repetitions. Advance only after several stable next mornings, with normal gait and push-off and no visible worsening of arch or heel position.

    My starting dose or notes

  3. Exercise 3

    Supported single-leg balance

    2 to 3 days per week

    Dose3 rounds of 30 to 60 seconds per side

    Stand on the involved leg on a firm floor with stable support within reach. Keep the knee and pelvis controlled while allowing the foot to move naturally within a tolerable range. Use the support when needed rather than forcing the arch to stay rigid.

    Make it easier

    Use fingertip support or keep the opposite toes on the floor.

    Progress it

    Add a small three-way reach or slow trunk rotation while keeping the knee and pelvis controlled. Keep the challenge within a range that preserves walking tolerance and the next-morning baseline.

    My starting dose or notes

  4. Exercise 4

    Squat to chair or supported split squat

    2 to 3 days per week

    Dose2 to 3 sets of 8 to 15 repetitions

    For the chair option, stand in front of a stable chair, keep the whole foot grounded, and sit back through a comfortable range before standing again. For the supported split squat, hold a rail, use a staggered stance, and bend both knees through a comfortable range. Keep foot pressure steady in either version.

    Make it easier

    Use a higher chair, shallower range, or more support.

    Progress it

    Choose a lower chair, split squat, or reverse lunge before adding light weight. Change one variable after several stable next mornings, preserving controlled foot pressure and normal walking and push-off.

    My starting dose or notes

  5. Exercise 5

    Supported single-leg hip hinge

    2 to 3 days per week

    Dose2 to 3 sets of 6 to 12 repetitions per side

    Stand on the involved leg with stable support within reach and soften the knee. Send the hips back as the trunk tips forward without twisting, then return upright. Keep foot pressure controlled and use the support as needed.

    Make it easier

    Use kickstand toes and hand support.

    Progress it

    Progress to a single-leg deadlift, add a knee drive, or hold weight in the opposite hand. Choose one change after several stable next mornings and keep the foot, knee, and pelvis controlled.

    My starting dose or notes

Optional video companion

See the movement principles in context.

The written program above remains the prescription. This independent third-party video adds a visual explanation of the condition and common exercise options.

E3 Rehab video

Tibialis Posterior Tendinopathy | Tendinitis | Dysfunction | Pain (Exercises, Rehab, Strengthening)

Third-party educational resource

YouTube content does not load until you choose this button.

The embedded chapter explains activity adjustment, supportive options, and progressive foot, calf, balance, and whole-leg exercise for tibialis posterior tendon pain.

Watch on YouTube (opens in a new tab)

Use with this program

Use this video for education and technique, not as a second exercise program. Follow the exercises, dose, progression, and symptom rules on this page. Video examples are options, not additions. Links or promotions inside the video are provided by E3 Rehab and are not part of this program. New arch collapse, inability to perform a heel raise, acute trauma, marked swelling, or suspected progressive collapsing foot deformity requires examination rather than unsupervised progression.

Symptom response

Let the next day guide the dose.

Establish a repeatable daily step baseline. If walking is provocative, temporarily use cycling or swimming. Increase steps, pace, hills, or running one variable at a time while monitoring gait, push-off, swelling, and foot shape.

Continue

Green light

Mild discomfort, normal gait and push-off, no visible worsening of arch or heel position, and symptoms return to baseline by the next morning.

Adjust

Yellow light

Medial ankle swelling, limping, walking tolerance, or next-morning pain is meaningfully worse. Reduce resistance, heel-raise range, repetitions, or daily steps by about 25 to 50 percent.

Stop

Red light

Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Stop for a pop, sudden weakness, inability to perform a heel raise, new or progressive arch collapse, focal bone pain, numbness, hot red swelling, or inability to bear weight. Seek same-day urgent assessment for inability to bear weight after trauma, visible or rapidly progressive deformity, a hot red markedly swollen foot with or without fever, especially with diabetes or reduced sensation, a wound with spreading redness, or severe unrelenting pain. Arrange prompt evaluation for a pop with sudden loss of push-off, new arch collapse, inability to perform a heel raise, rapidly increasing weakness, focal navicular bone pain, new numbness, or progressive rest or night pain.

Change one variable at a time

When symptoms are too reactive, first reduce range, resistance, repetitions, or frequency. When the current dose feels controlled for several sessions, progress only one of those variables.

Progression

Build capacity in stages.

  1. Stage 1: reduce overload and establish support

    Track daily steps. Consider supportive footwear or clinician-directed arch support. Use banded adduction, seated or double-leg heel raises, and supported balance.

  2. Stage 2: build tendon and calf capacity

    Progress adduction resistance, double-leg to single-leg heel raises, and squat, split-squat, or hip-hinge strength. Advance only after several stable next mornings.

  3. Stage 3: restore walking and stairs

    Add weighted heel raises, dynamic balance, step and lunge demands, then brisk walking and hills one variable at a time.

  4. Stage 4: return to running or sport when appropriate

    Use a graded walk-jog progression, then optional pogos, hops, and cutting only when there is no progressive deformity or instability and the examination supports impact loading.

Signs you are ready for the next stage

  • Thirty minutes of level walking and normal stairs do not worsen the next morning.
  • Twenty controlled single-leg heel raises can be completed with useful height and the base of the big toe grounded.
  • The arch and heel position do not show progressive change during loading.
  • Single-leg balance can be held for 45 to 60 seconds.
  • Ten controlled step-downs can be completed without a sustained flare.
  • After walking, stairs, heel raises, and step-downs are tolerated and assessment supports impact, begin with a small trial of low double-leg pogos. Clinician review is required when foot collapse was ever suspected. Progress toward single-leg contacts only when needed for the goal and tolerated without a next-day flare. These walking times and repetition counts are practical guideposts, not validated return-to-sport cutoffs. New or progressive arch change, loss of push-off, or instability requires reassessment regardless of the numbers.

When to schedule an evaluation

Schedule a reassessment for any new arch change, worsening push-off, recurrent swelling, inability to progress heel raises, no improving trend after six weeks, or persistent limits after eight to twelve weeks.

Call UCLA Orthopedics at 310-319-1234

Use this tracker through the first checkpoint above. Mark up to three key sessions each week, check weekdays for frequent work, and note symptoms, resistance, duration, or activity gains. Continue through a longer condition-specific trial when useful.

WeekKey sessionsDaily or most-day workNotes
123
1MTWTFSS
2MTWTFSS
3MTWTFSS
4MTWTFSS
5MTWTFSS
6MTWTFSS

Questions? Call UCLA Orthopedics at 310-319-1234.

Full guide and references: https://jeremyswishermd.com/tibialis-posterior-tendinopathy-exercises/

Clinical review: August 28, 2026. Independent professional site; not an official UCLA Health website. UCLA Health manages appointments and clinical communication.

Optional video: An E3 Rehab technique companion is available in the full online guide listed above.

General education only, not individualized medical advice. For a medical emergency, call 911.

Common questions

Questions about this program

Do flat feet mean this tendon is diseased?

No. Flat or pronated feet can be pain free. A new painful change, progressive flattening, and loss of function matter more than appearance alone.

Will exercise rebuild a collapsed arch?

Exercise may improve pain and capacity, but it is not proven to reverse structural progressive collapsing foot deformity. New or progressive deformity needs assessment.

Do I need an orthotic?

Orthoses or braces can reduce tendon and arch demand, and most trials combined them with exercise. The device and duration should fit symptoms and deformity rather than foot appearance alone.

Can I run?

First restore level walking, heel-rise capacity, and next-day stability. Then use walk-jog intervals on flat ground and change one training variable at a time.

Should I stretch the calf?

Gentle calf mobility can be used when ankle motion is clearly limited and it does not increase inner ankle or arch pain. Do not force an aggressive stretch through the painful tendon.

Evidence

Guidelines, reviews, and clinical studies

This plan translates current clinical guidance into a practical home program. The cited sources support the treatment principles, but they do not establish one universal exercise recipe for every patient.

Evidence and recommendations can change. Last clinical review: August 28, 2026.

Related care

Tendon principlesEvidence-based tendon care Open guide Different ankle tendonPeroneal tendinopathy exercises Open guide Different arch or heel painPlantar heel pain exercises Open guide

Need a diagnosis or progression plan?

Start with a focused sports medicine evaluation.

Call UCLA Orthopedics for the most direct scheduling path.

Call 310-319-1234View Clinic LocationsRequest on UCLA Health (opens in a new tab)