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Posterior Tibial Tendon Reconstruction Starter Exercise Guide

A short starting program — 8 exercises drawn from the full 44-exercise program. These are the movements most people begin with.

Before you begin. This is general guidance, not a personal prescription. If your surgeon or therapist has given you a different program or different limits, follow theirs.

1. Elevation & Swelling Control

Elevation & Swelling Control exercise illustration

What it helps: Bringing the leg up reduces swelling and supports healing in the early weeks — simple, and it speeds your comfort.

How often: several times a day.

  1. Lie back and prop the foot above the level of your heart on pillows.
  2. Rest like this regularly through the day, especially after being up.
  3. Use ice as directed by your surgeon.

Tip: Elevation is one of the most helpful things you can do early on.

2. Toe Flexion & Extension

What it helps: Keeps the toes moving and the blood flowing while the foot heals.

How often: 15-20 repetitions, a few times a day.

  1. Curl your toes downward, then straighten and spread them upward.
  2. Move only the toes — keep your ankle still in the boot or cast.

Tip: A gentle way to stay active in the first weeks.

3. Ankle Pumps

Ankle Pumps exercise illustration

What it helps: Keeps blood moving to reduce swelling and the risk of clots while you're less active — small, frequent, and important early on.

How often: 20 repetitions, several times a day.

  1. Flex your foot up, pointing your toes toward the ceiling.
  2. Point your toes down, away from your body.

Tip: Move slowly and with control.

4. Gentle Ankle Range of Motion

Gentle Ankle Range of Motion exercise illustration

What it helps: Eases motion back into the ankle so it stays supple, within the limits your surgeon sets.

How often: 2-3 sets of 10, as directed.

  1. Seated, slowly point your foot down and bring it back toward neutral.
  2. Gently move the foot side to side.

Tip: Stay within a comfortable, pain-free range — avoid forcing the foot.

5. Ankle Alphabet

Ankle Alphabet exercise illustration

What it helps: Moves the ankle through its full range while you trace each letter — restoring motion in every direction.

How often: 1-2 sets of A–Z, a few times a day.

  1. With the leg supported, slowly "draw" each letter of the alphabet using your big toe.
  2. Move from the ankle, keeping the leg still.

Tip: Move within a comfortable, pain-free range.

6. Standing Weight Shifts

What it helps: Gently retrains you to load each leg evenly and confidently — the first step back to steady, balanced walking.

How often: 2-3 sets of 10, daily.

  1. Stand holding a counter, feet hip-width apart.
  2. Slowly shift your weight from one foot to the other.
  3. Keep the movement smooth and controlled.

Tip: Let comfort guide how much weight you shift onto the surgical side.

7. Walking Program

Walking Program exercise illustration

What it helps: Comfortable, frequent walking keeps the joints loose, builds your stamina, and rebuilds confidence on your feet. Little and often beats long and tiring.

How often: throughout the day.

  1. Take short walks at a comfortable pace.
  2. Increase your distance gradually as you feel able.

Tip: Use your assistive device as directed.

8. Theraband Inversion

Theraband Inversion exercise illustration

What it helps: Strengthens the muscles that turn the foot inward, helping balance and steady the ankle.

How often: 2-3 sets of 10-15, daily.

  1. Sit with a band looped around the inside of your foot, anchored to the opposite side.
  2. Slowly turn your foot inward against the band.
  3. Return slowly.

Tip: Keep the motion controlled and within comfort.

See the complete 44-exercise program, phase by phase.

Recovery reading

Browse all exercise guides · Condition guides · Recovery education library

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These are general exercise guides, not a personal prescription. The repetitions and frequency shown are what's commonly used — your own surgeon or therapist may advise something different, and their guidance comes first.