Inclusion Criteria:

• Female post-menopausal women aged 40-55 years.
• Clinically diagnosed with Stage I or flexible Stage II posterior tibial tendon dysfunction according to the Johnson and Strom classification modified by Myerson confirmed by an orthopedic physician.
• Symptoms persisting for ≥ 3 months.
• Pain intensity of ≥3/10 on the Visual Analogue Scale (VAS) during weight-bearing activities.
• Medically cleared to participate in blood flow restriction resistance training.
• Symptoms located at the medial ankle or foot.
• Pain on palpation of the posterior tibial tendon.
• A positive double and/or single heel-rise test.
• Able to walk independently without assistive devices
• Body Mass Index (BMI) between 18.5 and <24.9 kg/m².
• Willingness to participate and provide written informed consent.

Exclusion Criteria:

• Rigidity of the hindfoot.
• Pain on palpation of the fibular muscles.
• History of corticosteroid injection in the tendon in a one-month period prior to the study onset.
• History of surgery to the hindfoot and/or ankle.
• History of previous surgeries to the musculoskeletal structures (i.e., bones, joint structures, nerves) in either limb of the lower extremities.
• History of a fracture in either limb of the lower extremities requiring realignment.
• Acute injury to musculoskeletal structures of other joints of the lower extremity in the previous three months, which impacted joint integrity and function (i.e., sprains, fractures) resulting in interruption of desired physical activity.
• Hip joint or knee joint replacement.
• Patients who were possibly at risk of adverse reactions of blood flow restriction (i.e., poor circulatory system, obesity, diabetes, arterial calcification, sickle cell trait, severe hypertension, or renal failure).
• Any neurological conditions that affect proprioception, such as polyneuropathy, multiple sclerosis, and sensory ataxia.
• Vestibular deficits and vision problems.