The posterior tibial tendon is a primary supporting tendon, responsible for supporting the arch of the foot. Overuse of the posterior tibial tendon can result in injury and is often the cause for posterior tibial tendon dysfunction. Also called PTTD, posterior tibial tendon dysfunction is caused by a change in the tendon which interferes with the tendon’s ability to maintain arch support. This results in the sufferer experiencing a flattening of the arch, which changes the gait and walking mechanics and can result in additional problems in the feet and ankles.

Often referred to as adult-acquired flatfoot, PTTD is the most common cause of flatfeet in adults. The condition often begins in just one foot but some people develop it in both feet. Posterior tibial tendon dysfunction is progressive and will continue to worsen without treatment. PTTD is brought on by overuse of the posterior tibial tendon and is most often seen after activities involving the tendon, such as running, hiking, or climbing stairs. Athletes often experience symptoms of PTTD as some sports activities require extreme use of the posterior tibial tendon.

PTTD

PTTD is the abbreviated and most commonly used name for Posterior Tibial Tendon Dysfunction. PTTD is common among athletes and most often occurs after activities that require a lot of use of the posterior tibial tendon, which is a major supporting tendon running along the heel of the foot, between the arch and the calf, responsible for supporting the arch of the foot.

Activities that could result in PTTD include walking, climbing stairs, and hiking. Certain sports, like long-distance running, that place a lot of emphasis on posterior tibial tendon use can also result in posterior tibial tendon injury and lead to PTTD.

What Causes Posterior Tibial Tendon Dysfunction?

Posterior tibial tendon dysfunction begins as an overuse injury that isn’t allowed to heal properly. As the injury continues, the tendon is damaged and progresses into PTTD. There are several other conditions similar to PTTD and the terms are used interchangeably, though the diagnosis and treatment of these conditions differ slightly from PTTD. Only a doctor can properly discern between these conditions and offer the correct treatment.

Conditions that are often confused with PTTD include Tibialis Posterior Tendinopathy, a painful and degenerative injury of the tibialis posterior and Posterior Tibial Syndrome, which is slightly different and is the result of a dysfunction in the muscles, rather than an overuse injury of the tendon. Both of these conditions are similar in symptoms to PTTD, but the causes and treatments vary slightly.

If you are experiencing adult-onset flatfeet, or if you have a painful calf and ankle that doesn’t heal with several days of rest and ice, you should be evaluated by a podiatrist. Dr. Jeffery Kleis, DPM, is a board-certified podiatrist, centrally located in Costa Mesa and serving all of Orange County and Southern California. Dr. Kleis has more than 25 years of experience treating all manner of foot and ankle disorders. He stays on the cutting edge of treatments and technology for podiatry, leading the field in the use of laser technology and acoustic-wave therapies.

To diagnose PTTD, Dr. Kleis will perform a complete examination, including a complete medical history. X-rays and other diagnostic tests may be required to rule out other causes for pain or to identify contributing conditions.

Once Posterior Tibial Tendon Dysfunction has been diagnosed, Dr. Kelis will recommend a course of treatment aimed at relieving the symptoms and healing the causes of your pain. Treatments may include injections, laser or acoustic-wave therapies, special exercises, or orthotic inserts. If these therapies fail to provide complete relief, Dr. Kleis may recommend surgery to lessen the pressure on the nerve or remove the nerve entirely.

Call (714) 760-4944 to schedule a consultation with Dr. Kleis regarding your Posterior Tibial Tendon Dysfunction symptoms and feel better faster! You can also book an appointment online.

Symptoms of Posterior Tibial Tendon Dysfunction

Symptoms of posterior tibial tendon dysfunction include pain, swelling, flattening in the arch of the foot, and rolling inward of the ankle.

• Pain – In the beginning, PTTD presents as pain along the inside of the foot and ankle. The area may be red and warm to the touch, as well.
• Swelling – The ankle and foot may begin to swell. 
• Flattening of the Arch – As the arch begins to flatten, the pain and swelling may be less than it was in the beginning, leading a person to ignore the symptoms and believe they are getting better. However, this is not the case and pain may increase later after the arch has completely flattened. 
• Ankle Roll – As the arch flattens, the ankle begins to roll inward and the foot and toes begin to turn outward. At this stage, the pain may move to the outside of the foot, as the ligaments and tendons on the outside of the foot are forced to compensate for the change in walking mechanics. 

If left untreated, PTTD will continue to worsen and the flatfeet may become irreversible. The tendon will deteriorate if not allowed to heal and the ankle may develop arthritis as it is forced to operate abnormally. 

If you are experiencing symptoms of posterior tibial tendon dysfunction, or if you are experiencing adult-onset flatfeet and don’t know why you should contact Dr. Kelis for a complete evaluation. Dr. Kleis will perform an exam and order any diagnostic tests that may be necessary to rule out other conditions and identify any contributing factors. These tests may include X-ray, ultrasound, or MRI. 

Once PTTD has been identified as the cause of your pain and discomfort, Dr. Kleis will devise a treatment plan that addresses the symptoms and provides healing for the underlying issues involved. Treatment may include braces, orthotic devices, immobilization, physical therapy, laser or acoustic-wave therapy, oral or injectable medications, and shoe modifications. Occasionally, surgery is required to address PTTD that fails to improve with less invasive treatments. Dr. Kleis has a wide range of non-invasive treatments available and will go the extra mile to ensure that surgery is avoided if at all possible. But, if surgery is necessary, Dr. Kleis has over 25 years of experience treating all manner of foot and ankle disorders and is your best choice for PTTD treatment.

To schedule an evaluation of your posterior tibial tendon disorder symptoms or adult-onset flatfoot, call (714) 760-4944 or schedule an appointment online. 

Posterior Tibial Tendon Dysfunction Treatment

When a person first experiences the symptoms of PTTD, such as pain along the inside of the foot and ankle accompanied by swelling and redness, at-home treatments may be appropriate to allow the posterior tibial tendon to rest and heal.

At-home treatments include:

• Rest – PTTD is an overuse injury of the posterior tibial tendon that isn’t allowed to rest and heal. When first experiencing pain and swelling along the inside of the foot and ankle, rest from strenuous exercise and allow the tendon plenty of time to recover.
• Ice – Ice can reduce the pain and swelling in the foot and ankle and allow the tendon to heal on its own.
• Medication – Over-the-counter medications like ibuprofen and naproxen sodium can aid in relieving pain and reducing inflammation of the tendon.
• Shoe Modification – If you suspect that the injury occurred due to improper arch or ankle support, changing your shoes or using an arch support insert may help in preventing further injury.

Doctor’s Treatment of PTTD

Once PTTD has been diagnosed in the doctor’s office, a variety of treatments and therapies may be prescribed. These include:

• Bracing – Special braces to support your foot and ankle may assist in avoiding further injury and allow the damaged tendon to heal.
• Orthotic Inserts – Shoe inserts may provide additional support to the arch and prevent further injury.
• Immobilization – Occasionally a boot or short-leg cast may be required to immobilize the foot and ankle and allow the tendon to heal.
• Crutches – If total rest is needed to allow for healing, you may need to rely on crutches or another mobility device to help avoid any weight bearing on the injured leg.
• Medications – Over the counter or injectable anti-inflammatory medications may be prescribed.
• Laser or Acoustic-wave Therapies– Low-level laser and acoustic wave therapies have proven helpful in stimulating healing in damaged tissues and nerves.
• Surgery – When non-invasive therapies have failed to provide relief, Dr. Kleis may recommend surgery.

Posterior Tibial Tendon Dysfunction Doctor

If you are experiencing the symptoms of posterior tibial tendon dysfunction or adult-onset flatfeet, or if you have a painful calf and ankle that doesn’t heal with several days of rest and ice, you should be evaluated by a podiatrist.

Dr. Jeffery Kleis, DPM, is a board-certified podiatrist, centrally located in Costa Mesa and serving all of Orange County and Southern California. Dr. Kleis has more than 25 years of experience treating all manner of foot and ankle disorders. He stays on the cutting edge of treatments and technology for podiatry, leading the field in the use of laser technology and acoustic-wave therapies.

To diagnose PTTD, Dr. Kleis will perform a complete examination, including a complete medical history. X-rays and other diagnostic tests may be required to rule out other causes for pain or to identify contributing conditions.

Once Posterior Tibial Tendon Dysfunction has been diagnosed, Dr. Kelis will recommend a course of treatment aimed at relieving the symptoms and healing the causes of your pain. Treatments may include injections, laser or acoustic-wave therapies, special exercises, or orthotic inserts. If these therapies fail to provide complete relief, Dr. Kleis may recommend surgery to lessen the pressure on the nerve or remove the nerve entirely.

Call (714) 760-4944 to schedule a consultation with Dr. Kleis regarding your Posterior Tibial Tendon Dysfunction symptoms and feel better faster! You can also book an appointment online.