Posterior Tibial Tendon Injury Exercises

• Prone hip extension: Lie on your stomach with your legs straight out behind you. Draw your belly button in towards your spine and tighten your abdominal muscles. Tighten the buttocks and thigh muscles of the leg on your injured side and lift the leg off the floor about 8 inches. Keep your leg straight. Hold for 5 seconds. Then lower your leg and relax. Do 2 sets of 15.
• Side-lying leg lift: Lie on your uninjured side. Tighten the front thigh muscles on your injured leg and lift that leg 8 to 10 inches away from the other leg. Keep the leg straight and lower it slowly. Do 2 sets of 15.
• Towel stretch: Sit on a hard surface with your injured leg stretched out in front of you. Loop a towel around your toes and the ball of your foot and pull the towel toward your body keeping your leg straight. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times.
• Standing calf stretch: Stand facing a wall with your hands on the wall at about eye level. Keep your injured leg back with your heel on the floor. Keep the other leg forward with the knee bent. Turn your back foot slightly inward (as if you were pigeon-toed). Slowly lean into the wall until you feel a stretch in the back of your calf. Hold the stretch for 15 to 30 seconds. Return to the starting position. Repeat 3 times. Do this exercise several times each day.
• Heel raise: Balance yourself while standing behind a chair or counter. Using the chair or counter as a support to help you, raise your body up onto your toes and hold for 5 seconds. Then slowly lower yourself down without holding onto the support. (It's OK to keep holding onto the support if you need to.) When this exercise becomes less painful, try lowering yourself down on the injured leg only. Repeat 15 times. Do 2 sets of 15. Rest 30 seconds between sets.
• Step-up: Stand with the foot of your injured leg on a support 3 to 5 inches high (like a small step or block of wood). Keep your other foot flat on the floor. Shift your weight onto the injured leg on the support. Straighten your injured leg as the other leg comes off the floor. Return to the starting position by bending your injured leg and slowly lowering your uninjured leg back to the floor. Do 2 sets of 15.
• Balance and reach exercises: Stand next to a chair with your injured leg farther from the chair. The chair will provide support if you need it. Stand on the foot of your injured leg and bend your knee slightly. Try to raise the arch of this foot while keeping your big toe on the floor.
  1. Keep your foot in this position. With the hand that is farther away from the chair, reach forward in front of you by bending at the waist. Avoid bending your knee any more as you do this. Repeat this 10 times. To make the exercise more challenging, reach farther in front of you. Do 2 sets of 10.
  2. Stand in the same position as above. While keeping your arch height, reach the hand that is farther away from the chair across your body toward the chair. The farther you reach, the more challenging the exercise. Do 2 sets of 10.

If you have access to a wobble board, do the following exercises:

• Wobble board exercises:
  1. Stand on a wobble board with your feet shoulder width apart. Rock the board forwards and backwards 30 times, then side to side 30 times. Hold on to a chair if you need support.
  2. Rotate the wobble board around so that the edge of the board is in contact with the floor at all times. Do this 30 times in a clockwise and then a counterclockwise direction.
  3. Balance on the wobble board for as long as you can without letting the edges touch the floor. Try to do this for 2 minutes without touching the floor.
  4. Rotate the wobble board in clockwise and counterclockwise circles, but do not let the edge of the board touch the floor.
  5. When you have mastered exercises A through D, try repeating them while standing on just your injured leg.

  After you are able to do these exercises on one leg, try to do them with your eyes closed. Make sure you have something nearby to support you in case you lose your balance.