Introduction Tibialis posterior tendinopathy is a disabling, frustrating, and progressive musculo-skeletal condition that is commonly seen in middle-aged women. The etiology of this overuse injury is likely to be multifactorial, so it is necessary to take into account intrinsic and extrinsic risk factors for effective treatment. Evidence of treatment protocol is insufficient and of limited quality. Conservative treatment is generally undertaken in the early stages of the condition. In conservative treatment, physical therapy and a program of eccentric strengthening exercises are especially emphasized. Case report We present a case of a 48-years-old woman diagnosed with tibialis posterior tendinopathy. The patient could not participate in recreational sports activities and had a significant limitation in walking. Over a five-weeks period the patient had ten sessions of physical therapy. The applied individually tailored physical therapy program was based on eccentric strengthening exercises. Conclusion The implemented physical therapy program has led to a significant reduction in pain and a return to sports activities. This case report shows that physical therapy program based on eccentric exercise regime can relieve symptoms and restore functional ability for short period in patient with tibialis posterior tendinopathy.