Posterior tibial tendon dysfunction (PTTD) is the term used when the tibialis posterior tendon is unable to perform its usual function.
This tendon serves as one of the major supporting structures of the foot and helps the foot to function while walking. In PTTD the tendon’s ability to perform that job is impaired, often resulting in a flattening of the foot.
PTTD is often referred to as a progressive condition meaning that the symptoms change the longer the condition is present. For example:
- When PTTD initially develops, typically there is pain on the inside of the foot and ankle (along the course of the tendon). In addition, the area may be red, warm, and swollen.
- Later, as the arch begins to flatten, there may still be pain on the inside of the foot and ankle. But at this point, the foot and toes begin to turn outward and the ankle rolls inward.
- As PTTD becomes more advanced, the arch flattens even more and the pain often shifts to the outside of the foot, below the ankle. The condition may progress to a point where the tendon may tear completely.
With appropriate and rapid treatment the progression of this condition can be slowed considerably or in some cases even ceased. Depending on the stage and acuteness of the presenting case, treatment can vary but will include one of more of the below: