The tibialis posterior muscle extends from tibia and fibula (lower leg bones), it then travels down the inside of the lower leg and ankle (behind the inner ankle bone) where it inserts into various bones in the foot via the tibialis posterior tendon. It is this insertion into various bones of the foot that is usually affected and results in severe mid-foot pronation (rolling inwards) and pain upon palpation of the tendon. The tibialis posterior muscle is responsible for maintaining the foot arch, moving the foot/ankle inwards and pointing the foot/ankle down.
Tibialis posterior tendon dysfunction is a common injury seen in running sports such as football, basketball, hockey and long distance athletes. Along with overuse, there are other factors that may predispose a person to this type of injury, for example, poor foot biomechanics, weight, training errors, joint stiffness, muscle weakness (particularly in the calf muscle), inadequate fitness etc.
Adequate rest along with specific exercise is the best form of recovery for this soft tissue injury. The following exercises should be also tried to help decrease inflammation and aid in the recovery process of the tendon.