Posterior Tibial Tendon Dysfunction

Posterior tibial tendon dysfunction (PTTD) is a painful condition that impacts the tendon supporting the foot’s arch. The posterior tibial tendon connects the calf muscle to the bones on the inner side of the foot. When PTTD occurs, the tendon will become inflamed or torn, causing instability in the arch and difficulty walking.


Posterior tibial tendon dysfunction (PTTD) is usually the result of overuse or a fall impacting the tendon. Age, excessive body weight, diabetes, hypertension, and previous foot and ankle injuries can also lead to the tendon breaking down faster. PTTD is also more common in women.


The most common symptoms of posterior tibial tendon dysfunction (PTTD) are pain and swelling in the foot or ankle. Pain is often worse with increased activity or standing for long periods of time. Over time, the ankle may roll inward and it will be difficult to walk on uneven surfaces or stairs.


Physicians will review symptoms and perform a physical examination to diagnose posterior tibial tendon dysfunction (PTTD). Factors physicians will look for include swelling, the ability to move the foot from side to side, and changes in the shape and structure of the foot. Imaging tests may also be used to provide a detailed view of the foot’s structure and the health of surrounding tendons and muscles.


Posterior tibial tendon dysfunction (PTTD) is usually treated with rest, ice, anti-inflammatory medications, physical therapy, and orthotics such as shoe inserts. In some cases, a cast or walking boot may be recommended. Surgical treatment is possible if pain does not improve.

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