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Any ideas on this? I have add it for almost a year from my running. i have had orthotics, I have had physical therapy, I have rested and nothing seems to help.
I have been seeing a lot more of this recently as more runners are starting to wear the newer minimal shoes and strike the ground with the forefoot.
Are you a forefoot striker? If you are, then the posterior tibial muscle has to work a lot harder. If that is the case, then get back to heal striking so that muscle does not have to work so hard. I have had to get a number of runners to do that recently with chronic posterior tibial tendonitis. They only started forefoot striking as they listened to all the rhetoric about getting less injuries that way. That was not the case for them.
See some of these:
https://podiatryarena.com/index.php?threads/26-yo-with-chronic-posterior-tibial-tendonitis.74635/
https://www.podiatrysoapbox.com/posterior-tibial-tendonitis/