Posterior Tibial Tendon Dysfunction(PTTD)

Posterior Tibial Tendon Dysfunction(PTTD)

Posterior Tibial Tendon Dysfunction (PTTD) refers to pain and problems with the tendon that crosses the inside of the ankle.  This tendon is responsible for turning your foot inward and helps support your arch during walking or running.  Having flat feet does not necessarily mean that you have PTTD.  However, if you have flat feet & experience pain on the inside of the ankle or arch, your doctor may diagnose your pain as PTTD.  In some cases, pain can refer to the bottom of the arch, but the pain is most commonly located on the inner side of the foot. If your pain is located at the back of the heel, you may be suffering from Achilles tendon pain instead. 



The most common cause of PTTD is degeneration or overuse to the tendon with repetitive movements. These movements cause your arch to gradually flatten over time (an acquired deformity).  Some patients with an acquired deformity have weakness or poor control of their hip muscles.  During walking, poor hip control can cause your knee to rotate inward and your arch to flatten when walking.  Obesity can contribute to the problem as well.  The added weight puts more stress on your tendon as you take each step. Another cause is the long-term use of corticosteroids, like Prednisone, which can cause the tendon to become weaker and allow your arch to gradually fall.   Last, if you were born with a severe flat-foot deformity, you likely have no control over your arch structure.  More support, like orthotics, may help to reduce your pain.

PTTD can become very persistent over time, so seeking help in the early stages is wise.  Learning the best type of foot support and exercises for your foot type is important.  If you have flat feet and are unsure if shoes, orthotics, or braces may help your foot pain.

Physical therapy at SOS PHYSIO Rehab

Physical therapy can help you learn how to improve the control of your muscles and provide hands-on techniques to decrease pain. Physical therapy focuses on helping you regain:

  • Normal range-of-motion of your foot and ankle
  • Strength
  • Mobility

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