Healthy Runner Podcast 89. Posterior Tibial Tendonitis Treatment for Runners with Dr. Duane Scotti, DPT, PhD
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Sep 16, 2021 Discussion centers on identifying inside-ankle pain and when it signals posterior tibial tendon issues. They cover tendon anatomy, why runners develop this pain, and staging severity. Practical topics include progressive tendon loading, specific foot and hip exercises, mobility and soft-tissue care, and training modifications to stay active while recovering.
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Tendon Pain Means Load Mismatch Not Failure
- Posterior tibial tendon pain is an overuse problem showing your body isn't ready for running load rather than a moral failure of the runner.
- Dr. Duane Scotti explains it signals insufficient conditioning, not simply 'too much running' or inherent inability to run.
Injections May Mask Problem And Increase Risk
- Steroid injections can reduce short‑term pain but risk masking load limits and increasing rupture risk if root causes aren't fixed.
- Research and clinical experience show exercise‑based loading outperforms injections for tendon recovery.
How Posterior Tibial Pain Shows Up Differently
- Posterior tibialis issues can present as shin pain (medial shin splints) or ankle swelling depending on whether the muscle belly or tendon is involved.
- Dr. Duane Scotti notes the tendon sits at the medial ankle and the muscle runs higher on the inside shin, causing varied symptoms.