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Posterior Tibial Tendon Dysfunction

PTTD is one of the more painful conditions that can affect the 20% of Americans who develop flat feet.

PTTD is the painful irritation and weakening of the key tendon that connects to the inside edge of the foot at the arch.

PTTD can be a result of an injury, pregnancy, arthritis or diabetes, but generally it's the result of wear and tear. A person with PTTD will suffer pain and swelling while standing that increases when they try to stand on their toes. If left untreated, the tendon can develop severe tendinosis or degeneration, rupture and lead to the collapse of the arch of the foot and potentially arthritis.

Treatment Options

PTTD progresses quickly, so it's important to see a foot and ankle expert at the first sign of symptoms. PTTD can usually be addressed without surgery if diagnosed early. Treatments may include:

  • Orthotic devices (specially fit shoe inserts) or bracing. Additional support to your arch helps relieve stress on the Posterior Tibial tendon and gives it time to heal. Orthotics and braces can be worn with your existing footwear.
  • Immobilization. A boot or cast may be used to hold your foot in place to help the tendon heal, otherwise a patient may be directed to use crutches or to simply stay off their feet.
  • Shoe choice. All shoes are not created equal. There are specific designs to help with this condition. A foot and ankle specialist can help you determine the best footwear for healing and preventing PTTD, such as inserts for your existing shoes or recommendations for new shoes altogether.

Early diagnosis of PTTD is the best way to avoid surgery and painful long-term complications. A foot and ankle expert can identify your condition and treatment options. If you have additional questions, please refer to our PTTD FAQ for
more information.

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