Posterior Tibial Tendon Dysfunction

What is Posterior Tibial Tendon Dysfunction?

The posterior tibial tendon is a crucial support structure for the foot and aids in walking. Posterior Tibial Tendon Dysfunction (PTTD) is a problem that occurs due to changes in this tendon. As a result the body's ability to support the arch of the foot is affected. PTTD is sometimes referred to as adult acquired flatfoot because it is the leading cause of flat feet developed in adulthood. It is more common for the condition to develop in one foot than in both. It is a progressive disorder and will only worsen if there is no medical intervention.


The cause of PTTD is most commonly overuse of the posterior tibial tendon. Activities such as running, walking and hiking have all been found to be potential causes when done in excess. 


Treatments for PTTD include:

  • Orthotic Insoles - Custom orthotics, often along with additional bracing are used to provide more support.

  • Immobilization - restricting and protecting the foot in a cast, splint, or boot is commonly used to allow the tendon to heal.

  • ​Oral Medications - Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, may be used to reduce inflammation and pain.

  • Physical therapy - Common therapy may include strengthening exercises, soft-tissue massages, stretching and ultrasound therapy.

  • Shoes - a change to shoe gear, especially to a shoe which provides more support to the arch.

While most patients experience positive results with non-invasive treatments, your podiatrist may suggest surgical intervention if these other treatments produce no positive results. 

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