Still dealing with foot or ankle pain even after orthotics, stretching, rest, or “doing all the right things”?
In this episode, Craig and Alex break down why posterior tibialis pain is so commonly misdiagnosed, poorly treated, and stuck in a loop of temporary fixes. They explain why flat feet aren’t the real problem, how overloaded muscles and poor force absorption keep the tendon irritated, and why tools like taping and bracing work—when they’re used correctly.
You’ll learn how to actually test whether the posterior tibialis is the source of your pain, how to unload it without becoming dependent on orthotics, and how to rebuild capacity so the problem doesn’t keep coming back.
Whether you’re an active adult, runner, clinician, or someone frustrated that your foot “just won’t heal,” this episode gives you a clearer path forward.
If you are struggling with heel pain (pain on the bottom of your foot, not the inside) check out our article about the most common cause of heel pain in our article “7 Signs Your Heel Pain Isn’t Plantar Fasciitis (and What’s Really Causing It)“
In this episode:
– What posterior tibialis pain actually is (and why it’s often missed)
– How to tell if medial ankle pain is coming from the post tib tendon
– Why foot structure matters less than load and control
– The difference between pronation and rate of pronation
– Why muscles above and below the foot overload the post tib
– How deep calf tightness can signal tendon overload
– When cross-friction, taping, and bracing make sense
– Modified Low Dye taping and artificial stabilization explained
– Why orthotics often delay recovery instead of fixing the issue
– How to progress rehab without triggering another flare-up
– Common mistakes that keep posterior tib pain coming back
Chapters
00:00 – Intro & Why Alex Doesn’t Like Clinical Episodes
02:00 – What Is Posterior Tibialis Pain?
04:00 – Key Signs and How to Test It Yourself
07:00 – Structure vs Function: Flat Feet, Rigid Feet, First Ray Drop
10:00 – The Pronation Myth
13:00 – Overloaded Muscles and Recurrent Injury
17:00 – Cross Friction, Taping, and the Treatment Hierarchy
20:00 – Why Taping Works (and When to Use It)
22:00 – Modified Low Dye Taping Explained
25:00 – Compression Wraps and Bracing Progression
28:00 – Orthotics vs Strengthening
31:00 – Rehab Progression and Functional Benchmarks
35:00 – Biggest Mistakes in Post Tib Rehab
🎙️ About Past Your Prime Podcast
Past Your Prime is the podcast for active adults balancing training, rehab, family, and real life.
Hosted by Craig Smith (PT & SPC Founder) and Alex Keicher (professional athlete and working dad) and presented by Smith Performance Center.
