ConditionDiagnosisDifferential diagnosisTreatment
Posterior tibial tendinopathyPain and swelling posterior to the medial malleolus
Pain worse with weight bearing and with inversion and plantar flexion against resistance
Deltoid ligament sprain
Flexor digitorum longus injury
Flexor hallucis longus injury
Navicular stress fracture
Tarsal tunnel syndrome
PRICEMM
Foot orthosis to decrease pronation
Posterior tibial tendon strengthening
Consider immobilization in short leg cast for two to three weeks
Peroneal tendinopathyPain and swelling posterior to the lateral malleolus
Pain with active eversion and dorsiflexion against resistance
May have a history of chronic lateral ankle pain and instability
Ankle sprain
Fibular fracture
Peroneal subluxation or dislocation
Os perineum syndrome
PRICEMM
Foot orthotic
Lateral heel wedge
Eversion strengthening
Achilles tendinopathyPain, swelling, and/or crepitus at the tendon (often 3 to 5 cm above insertion to calcaneus)
Recent change in intensity or duration of training
Hamstring and gastrocnemius-soleus complex-soleus inflexibility
Achilles rupture (partial or complete)
Retrocalcaneal bursitis
PRICEMM
Gastrocnemius and soleus stretching
Eccentric strengthening program
Flexor hallucis longus tendinopathyPain and swelling over the posteromedial aspect of the ankle
Seen in dancers or athletes who use repetitive push-off maneuver
Pain with resistive flexion of the great toe
Osteoarthritis
Osteochondritis of talus
Posterior impingement
Posterior tibial tendinopathy
PRICEMM
Shoe with a firm sole
Core strengthening
Anterior tibial tendinopathyPain over the anterior ankle
Weak dorsiflexion of the foot
Caused by forced dorsiflexion
Anterior tibial rupture
Lumbar radiculopathy
Peroneal nerve palsy
PRICEMM
Immobilization in short leg cast
Dorsiflexor strengthening