There are a number of tendons in the foot and ankle region and all are important to normal walking and running. They are strong structures capable of taking great loads – but they will become injured if the nature of this loading is disrupted by poor training, overloading, or faulty biomechanics of the foot and lower limb, or indeed a combination of all of the above.

Achilles Tendonitis / Tendinosis
The Achilles tendon is attached to the powerful muscles of the calf – soleus and gastrocnemius and these attach via the Achilles tendon to the heel bone – the calcaneus.

In walking and running they act in a number of ways that can leave them prone to injury if the foot is unstable or prone to excessive pronation.

The primary function of the muscle / tendon combination is to slow down the forward motion of the shin bone (tibia) and to moderate knee extension when weight-bearing while the body moves over the planted foot. It acts as a stabiliser of the lower leg in the stance (the supporting foot) phase of gait.

To learn more about Achilles tendon injuries go here.

Posterior Tibial Tendinitis / Tendinosis
The tibialis posterior muscle lies deep in the calf region and has a long tendon that runs down just behind the bony prominence on the inside of the ankle to instep of the foot. It supports the arch of the foot and acts in tandem with the calf muscles to stabilise the foot and leg in weight bearing activity – walking and running.

The tendon can become injured when the mechanics of the foot are at fault, especially where there is over-pronation present, and this gives rise to pain in the inner ankle area that does not go away with rest. The pain is often also in the inner shin area where the tibialis posterior muscle attaches to the shin bone (tibia).

Treatment of tibialis posterior tendon injuries generally involves using orthotic devices, running shoe advice, and physiotherapy.

Plantar Fasciitis
Pain in the heel can be associated with this condition. Although not a true tendon – it can be associated with faulty foot mechanics – see plantar fasciitis for a full explanation.