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What is Tibialis Posterior Strain?

Tibialis Posterior is located deep in the posterior compartment of the lower leg. It’s the inflammation or tear of the posterior tibial muscle located in the calf.

Causes/ etiology

This often occurs in endurance athletes particularly triathletes due to the repetitive motions which occur while training (running, cycling, and swimming). Therefore these athletes who train over extended periods of time have an increased risk of overuse trauma. Poor running mechanics, training errors, hill training, speed training and increasing distances rapidly increases the risk of injury. Swimming which involves maintaining pointed toes and shortening the calf muscles is associated with posterior calf tightness and therefore straining the tibialis posterior.


Swelling and edema posterior to the medial malleolus with pain and inability put weight on the foot, which is aggravated by standing or walking leading to gait dysfunction.


Treatment generally can be conservative without surgery using orthotics or braces.
Acute management should include P.R.I.C.E.: Protection, Relative Rest, Ice, compression and Elevation. Followed by a rehab program focused on strengthening the surrounding muscles of the calf and training the muscle for more long term endurance as this is commonly an injury which occurs through overuse.

Written by Chelsea Herana

Chelsea completed a Bachelor of Health and Medical sciences at Adelaide University in 2020 and Masters of Physiotherapy at Flinders University in 2022. Chelsea has had a variety of clinical experience including private practice, acute inpatient care and developing exercise programs for individuals with neurological conditions.

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