The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction
(PTTD) is a condition caused by changes in the tendon, impairing its ability to support
the arch. This results in flattening of the foot. PTTD is often called adult acquired flatfoot because it is the most common type of flatfoot developed during adulthood. Although this condition
typically occurs in only one foot, some people may develop it in both feet. PTTD is usually progressive, which means it will keep getting worse, especially if it isn't treated early.
Adult flatfoot typically occurs very gradually. If often develops in an obese person who already has somewhat flat feet. As the person ages, the tendons and ligaments that support the foot begin to
lose their strength and elasticity.
Pain along the inside of the foot and ankle, where the tendon lies. This may or may not be associated with swelling in the area. Pain that is worse with activity. High-intensity or high-impact
activities, such as running, can be very difficult. Some patients can have trouble walking or standing for a long time. Pain on the outside of the ankle. When the foot collapses, the heel bone may
shift to a new position outwards. This can put pressure on the outside ankle bone. The same type of pain is found in arthritis in the back of the foot. Asymmetrical collapsing of the medial arch on
the affected side.
Examination by your foot and ankle specialist can confirm the diagnosis for most patients. An ultrasound exam performed in the office setting can evaluate the status of the posterior tibial tendon,
the tendon which is primarily responsible for supporting the arch structure of the foot.
Non surgical Treatment
Initial treatment is based on the degree of deformity and flexibility at initial presentation. Conservative treatment includes orthotics or ankle foot orthoses (AFO) to support the posterior tibial
tendon (PT) and the longitudinal arch, anti-inflammatories to help reduce pain and inflammation, activity modification which may include immobilization of the foot and physical therapy to help
strengthen and rehabilitate the tendon.
For patients with a more severe deformity, or significant symptoms that do not respond to conservative treatment, surgery may be necessary. There are several procedures available depending on the
nature of your condition. Ligament and muscle lengthening, removal of inflamed tendon lining, transferring of a nearby tendon to re-establish an arch, and bone realignment and fusion are examples of
surgical options to help with a painful flatfoot condition. Surgery can be avoided when symptoms are addressed early. If you are feeling ankle pain or notice any warmth, redness or swelling in your
foot, contact us immediately. We can create a tailored treatment plan to resolve your symptoms and prevent future problems.