Posterior Tibial Tendon Dysfunction

What is PTTD?

Posterior Tibial Tendon Dysfunction (PTTD) describes the damage to and inflammation of a particular tendon that runs down the inside of your leg and beneath your foot. It is called the posterior tibial tendon.

What causes PTTD?

When the tendon is stressed and strained past a point that it can naturally handle, damage and pain occur. Because of the role of this tendon in supporting the foot, it means that its ability to support the arch and allow you to walk comfortably and without pain is also impaired. 

If left untreated, the injury often worsens. The tendon can be damaged from :

• Overuse from sports like running, long-distance walking, hiking and activities like
• Faulty foot biomechanics that overload the tendon
• Poor footwear that causes the tendon to overwork
• A high body mass index that places more strain on the tendon

What are the symptoms?

Pains on the inside of the ankle, in the arch and along the tendon are indications that there may be an issue. Other symptoms of PTTD may include:

• Swelling
• Flattened arch
• Inward rolling of the ankle

If the condition is left untreated, pain can migrate from the inside to the outside of the foot. Arthritis can develop as tendon deterioration advances. 

How is it treated?

Custom orthotic devices, immobilisation casts or boots, and strengthening exercises through physical therapy can correct the condition during the early stages of PTTD. In extreme cases, surgery may be required to fix the issue and alleviate pain.