The tibialis posterior muscle originates on the inner posterior borders of the tibia and fibula.

The tendon of tibialis posterior muscle descends posterior to the medial malleolus and terminates by dividing into plantar, main, and recurrent components.

In the 'deep layer' of posterior muscles Tibialis posterior muscle arises proximally on the back of the interosseous membrane and adjoining bones and divides into two parts in the sole of the foot to attach to the tarsus.

It marks the lower limit of the insertion of the Popliteus, serves for the attachment of the fascia covering this muscle, and gives origin to part of the Soleus, Flexor digitorum longus, and Tibialis posterior muscles.

The tendon of the flexor digitorum longus muscle forms two: the crural chiasm (with the tendon of the tibialis posterior muscle) and the plantar chiasm (with the tendon of the flexor hallucis longus muscle).

This results from either sustained stress to the medial aspect of the tibia, which can precede an actual stress fracture, or when the outer surface (periosteum) of the medial tibia is irritated by the close attachments of the soleus and tibialis posterior muscle.

On the other side of the fascia are the tibialis posterior muscle, the flexor digitorum longus muscle, and the flexor hallucis longus muscle, along with the posterior tibial artery and posterior tibial vein and the tibial nerve.

An example of an intrinsic factor for tendinopathies are: poor biomechanics such as limb malaligments and hyperpronation that may cause increased traction loads acting on the foot and ankle that may increase the incidence of Achilles, flexor hallucis longus muscle, and tibialis posterior muscle tendinopathies.