Exercises I do for Posterior Tibial Tendon issues

A few people have asked me what physical therapy exercises I've been doing to strengthen my posterior tibial tendon. I thought I'd post the answer here in case anyone reading would like some information too.

After a 10 minute warm up of either walking, jogging or cycling I do 2 minutes worth of heel walking with the toes pointed straight up, then walk normal for about a minute to recover, then 2 more minutes of heel walking with my toes pointing out to the sides, then recover.

Then I walk for a minute with the outer edges of my feet (so my arches are kind of facing each other). This mimics an ankle twist. Then I walk for a minute on the insides of my feet with the soles of my feet facing out (mimicking ankle twist/exaggerated pronation).

I do various stretches that mimic over pronation and supination.

I also stand on one foot and 'write out' the letters of the alphabet in the air with my other foot. Do both feet. This helps improve your balance.

I grab imaginary objects with my toes... will do about 60 grabs per foot, rest, and then 60 more per foot (strengthens the arches).

I massage both posterior tibial tendon areas, and I roll the heck out of my calves on a foam roller.

I do a ton more ancillary exercises that help with balance and ankle strengthening, but these are the ones I do several times a week.

We are constantly moving FORWARD when we run or cycle or swim... so a couple times per week I will run backwards for 100 yards for every mile I run (only on a short run day). I will also 'run' laterally, alternating crossing my feet in front and back as I move. I will also do lateral moving squats. I do all these on the run. On those days I will also do some 'bounding' type movements like exaggerated skipping with really high knees. Or I will do burpees.

There's a lot of information on the 'net about posterior tibial tendinitis, with good exercise/stretching suggestions to improve the situation and prevent it from coming back.