Tibialis Posterior Muscle – Anatomy, Nerve Supply, Function

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 4 min read

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Article Summary

Tibialis Posterior Muscle originating from the proximal tibia and fibula, passes distally with a broad insertion on the plantar aspect of the navicular, cuneiform, cuboid, and metatarsal bases and normally functions to invert the subtalar joint and to adduct the forefoot. Its principal antagonist is the peroneus brevis, which normally everts the subtalar joint and abducts the forefoot. Posterior tibial tendon dysfunction is a condition, as its name...

Key Takeaways

This article explains Anatomy of Tibialis Posterior Muscle in simple medical language.
This article explains Nerve Supply of Tibialis Posterior Muscle in simple medical language.
This article explains Blood Supply of Tibialis Posterior Muscle in simple medical language.
This article explains The Function of Tibialis Posterior Muscle in simple medical language.

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Definition

Tibialis Posterior Muscle originating from the proximal tibia and fibula, passes distally with a broad insertion on the plantar aspect of the navicular, cuneiform, cuboid, and metatarsal bases and normally functions to invert the subtalar joint and to adduct the forefoot. Its principal antagonist is the peroneus brevis, which normally everts the subtalar joint and abducts the forefoot. Posterior tibial tendon dysfunction is a condition, as its name suggests, that is characterized by the loss of function of the posterior tibial tendon.

Anatomy of Tibialis Posterior Muscle

The tibialis posterior muscle originates on the inner posterior borders of the tibia and fibula. It is also attached to the interosseous membrane, which attaches to the tibia and fibula.

The tendon of the tibialis posterior muscle (sometimes called the posterior tibial tendon) descends posterior to the medial malleolus and terminates by dividing into plantar, main, and recurrent components. The main portion inserts into the tuberosity of the navicular and the plantar surface of the medial cuneiform. The plantar portion inserts into the bases of the second, third and fourth metatarsals, the intermediate and lateral cuneiforms and the cuboid. The recurrent portion inserts into the sustentaculum tali of the calcaneus.

Tibialis posterior is also related to some important neurovascular structures. For example, it lies anterior to the posterior tibial artery, which gives off a branch called the fibular artery. The fibular artery descends between the fibula and tibialis posterior. The anterior tibial artery travels between the medial and lateral parts of the muscle, close to its origin points. The tibial nerve travels over the tibialis posterior for most of its course.

Origin: The superior two-thirds of the medial posterior surface of the tibia
Insertion: The tendon courses distally, splitting into two at the calcaneonavicular ligament, to insert on the tuberosity of the navicular bone (superficial slip) and the plantar surfaces of the metatarsals two to four (deep slip)
Action: The posterior tibialis is the primary inverter of the foot but also adducts, plantar flexes, and aides in supination of the foot
Blood Supply: Sural, peroneal, and posterior tibial arteries
Innervation: Tibial nerve

Nerve Supply of Tibialis Posterior Muscle

Tibialis posterior is innervated by the tibial nerve which arises from the L4 and L5 spinal nerves. The tibial nerve is the larger of the two branches of the sciatic nerve.

Blood Supply of Tibialis Posterior Muscle

Blood supply to the tibialis posterior muscle is through branches of the posterior tibial artery, which stems the popliteal artery. These branches include the fibular and medial plantar arteries. The medial malleolar arterial network also contributes to the blood supply of the tendon. Tibialis posterior is drained by the posterior tibial veins, which empty into the popliteal vein.

The Function of Tibialis Posterior Muscle

As well as being a key muscle and tendon for stabilization, the tibialis posterior also contracts to produce inversion and assists in the plantar flexion of the foot at the ankle. The tibialis posterior has a major role in supporting the medial arch of the foot. Dysfunction of the tibialis posterior, including rupture of the tibialis posterior tendon, can lead to flat feet in adults, as well as a valgus deformity due to unopposed eversion when inversion is lost.

Tibialis posterior is involved in movements at two different joints, as follows

Plantar flexion of the foot at the talocrural (ankle) joint.
Inversion of the foot at the subtalar joint.

Through its action on the ankle joint, the tibialis posterior helps the other, more powerful foot flexors to elevate the heel when the foot is planted on the ground. This facilitates walking, running and various fitness exercises, such as calf raises. In addition, the contraction of the tibialis posterior approximates the tibia and fibula. This brings the malleoli together during plantar flexion, improving their grip on the talus and supporting the ankle. The inversion of the foot also has several important functions. Through this action, the tibialis posterior resists the tendency of the body to sway laterally when standing on one leg, thus facilitating balance.

This muscle also plays a support role by elevating, tensing, and reinforcing the medial longitudinal arch of the foot. This action helps to distribute the body weight when the foot is planted on the ground.

References

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

Write when the problem started and how it changed.
Bring old prescriptions, investigation reports, and current medicines.
Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

What is the most likely cause of my symptoms?
Which danger signs mean I should go to hospital quickly?
Which tests are necessary now, and which can wait?
How should I take medicines safely and what side effects should I watch for?
When should I come for follow-up?

Tests to discuss

Vital signs: temperature, pulse, blood pressure, oxygen saturation
Basic physical examination by a clinician
CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

Rest, drink safe water, and observe symptoms carefully.
Keep a written note of symptoms, duration, temperature, medicines already taken, and allergy history.
Seek medical care quickly if symptoms are severe, worsening, or unusual for the patient.

OTC medicine safety

For mild pain or fever, ask a registered pharmacist or doctor before using common over-the-counter pain/fever medicines.
Do not combine multiple pain medicines without advice, especially if you have kidney disease, liver disease, stomach ulcer, asthma, pregnancy, or take blood thinners.
Do not give adult medicines to children unless a qualified clinician advises it.

Avoid these mistakes

Do not start antibiotics without a proper medical decision.
Do not use steroid tablets or injections casually for quick relief.
Do not delay emergency care because of home remedies.

Get urgent help if

Severe symptoms, confusion, fainting, breathing difficulty, chest pain, severe dehydration, or sudden weakness need urgent medical care.

Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider

Tests to discuss with doctor

Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
Relevant blood, urine, imaging, or specialist tests only after clinical assessment

Questions to ask

What is the most likely cause of my symptoms?
Which warning signs mean I should go to emergency care?
Which tests are really needed now?
Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Go to emergency care if you notice:

Severe or rapidly worsening symptoms
Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration

Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.

Step 1
Check danger signs first

If danger signs are present, seek emergency care and do not wait for online information.
Step 2
Record the symptom story

Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.
Step 3
Visit a qualified clinician

A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.
Step 4
Do only useful tests

Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.
Step 5
Follow up and return early if worse

If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips

Take a written symptom diary and all previous prescriptions/test reports.
Do not hide medicines already taken, even herbal or over-the-counter medicines.
Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

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