Pain along the inside of the foot, extending down the arch and near the ankle bone, is a common complaint aggravated by walking or prolonged standing. This discomfort signals strain or damage to the structures maintaining the foot’s support system. The pain results from the foot’s inability to handle movement forces, which stresses the tendons and ligaments forming the inner arch.
Primary Causes Related to Tendon Dysfunction
The most frequent source of inside foot pain during walking is dysfunction of the Posterior Tibial Tendon (PTT). This tendon travels from the calf muscle, wraps around the inner ankle bone, and attaches to the foot bones to support the arch. Its primary function is to lock the midfoot bones in place, preventing the arch from collapsing during the gait cycle.
When the PTT is subjected to excessive strain, it may become inflamed (tendinitis). This initial stage presents as tenderness and swelling along the tendon’s path on the inside of the ankle. If strain continues, the tendon degenerates, leading to Posterior Tibial Tendon Dysfunction (PTTD) or tendinosis.
As the tendon weakens, it cannot sustain the tension required to support the arch. This failure causes the arch to gradually flatten, resulting in adult-acquired flatfoot. The arch collapse further stretches the compromised tendon and ligaments, creating a cycle of increasing pain and instability. Pain is typically most noticeable during high-impact activities or when pushing off the ground while walking.
Structural Factors and Arch Support
The underlying structure of the foot often predisposes individuals to PTTD and other forms of medial foot pain. The primary biomechanical factor contributing to this issue is overpronation, which describes the excessive inward rolling of the foot after the heel strikes the ground during walking. While a degree of pronation is natural for shock absorption, too much of this movement destabilizes the foot and causes the medial arch to collapse beyond its functional range.
This excessive inward roll places a lengthening force on the Posterior Tibial Tendon, forcing it to work harder and for a longer duration than intended to stabilize the foot. The constant tension on the tendon makes it susceptible to strain and eventual dysfunction. Overpronation also results in the heel tilting outward, which alters the alignment of the joints and increases the stress on the entire lower leg.
Structural issues like acquired flat feet, characterized by a diminished or collapsed arch, are directly related to overpronation and create a vulnerability to arch strain. Furthermore, the excessive stretching from a flattening arch can also aggravate the plantar fascia, the thick band of tissue running along the sole of the foot. Strain on the plantar fascia can radiate pain into the medial arch, sometimes mimicking or compounding the symptoms of tendon dysfunction.
Initial Home Management and Relief Strategies
Immediate relief for medial foot pain focuses on reducing the mechanical load on the stressed structures. The Rest, Ice, Compression, and Elevation (RICE) protocol is a starting point for managing initial inflammation. Resting the foot by reducing prolonged standing or walking allows the overworked tendon to recover.
RICE and Stretching
Applying ice along the inner ankle bone and arch helps reduce localized swelling and discomfort. Ice should be applied for fifteen to twenty minutes, several times daily, especially after activity. Gentle stretching of the calf muscle can also relieve tension on the Posterior Tibial Tendon.
Footwear and Support
Selecting appropriate footwear is a powerful self-management tool, focusing on firm arch support and adequate cushioning. Avoid flat, unsupportive shoes or walking barefoot, as these place maximum strain on the arch. Over-the-counter arch supports or insoles can help control overpronation and reduce excessive forces.
If the pain worsens, swelling increases, or if discomfort persists after two weeks of consistent home care, seek professional medical attention.