■■■
■■■
■■■

Posterior Tibial Tendon Dysfunction

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.

 

 

 

CONTACT FORM

WE WOULD LOVE TO HEAR FROM YOU

Call us at 714-760-4944 or fill out the contact form above with your info.

Diabetes is a disease where the body can’t remove glucose from the blood. The hormone insulin is created by the pancreas and used to move sugar from the bloodstream and into the muscles where the body can use it for energy. In diabetic patients,...

learn more

Plantar warts are non-cancerous growths that occur on the bottom of the feet. Plantar warts are caused by particular strains of the HPV virus that enters the body through tiny cracks or breaks in the skin of the foot. All warts are caused by...

learn more

While the majority of children may not need a podiatrist while they’re young, some parents may have concerns about the way their children are walking or the way their feet or ankles are developing. Some of the conditions common to children like...

learn more

Ingrown toenails are a common problem in adults and teens where the edge of the toenail digs into the skin of the toe and the toenail grows into the flesh of the toe. The condition is painful and can become more painful if left untreated....

learn more

An infection is defined as the invasion of the body and the body’s tissues by a foreign organism that reproduces and causes disease. Not all infections result in serious disease. However, any potential infection of the body should be guarded...

learn more

Calluses are thick areas of skin that develop on the hands and feet in response to repeated friction or pressure. These thick pads of skin are the body’s defense against potential injury, as the area of the hands or feet that experience abnormal...

learn more

Athlete’s foot is an uncomfortable and unsightly condition resulting from a fungal infection on the skin of the foot. Athlete’s foot generally begins between the toes, caused by sweaty feet being trapped in tight-fitting shoes. Athlete’s foot is...

learn more

What is hammertoe? A hammertoe deformity occurs when the toe joints bend abnormally to resemble a hammer, or an upside-down V when viewed from the side. This podiatric condition can affect any toe but is most common in the second through fifth...

learn more

We ask a lot of our feet. Every day, all day long, we require our feet and legs to carry us around and perform without complaining. So, when our feet hurt, we take notice! Tired, achy feet at the end of the day are one thing, but when we experience...

learn more

Bunions are a common foot problem that develops over time, usually caused by a combination of genetic factors and shoe-wear habits. While bunions can be painful, they do not always require intervention by an orthopedic doctor, like Dr. Kleis....

learn more

What is an ingrown toenail? Ingrown toenails are a common condition that occurs when the corner of your nail curves and grows into the surrounding skin. When the nail digs into the skin, the surrounding tissue becomes irritated and inflamed,...

learn more

Xerosis is a common condition. So common, in fact, that nearly every person will experience xerosis at least once in their lifetime. Xerosis is simply the medical term for very dry skin. It is derived from the Greek words “Xero” meaning dry and...

learn more

Our feet take a beating daily. We use our feet for nearly everything that we do, often taking their function and health for granted until something goes wrong. Keeping our feet healthy and strong will pay dividends in every area of our...

learn more

Sprains and strains are common injuries that affect the soft tissues surrounding the joints in the body. Both injuries are similar in their symptoms. They are painful, with swelling and redness often occurring in the injured area. While a sprained...

learn more

Runners put their bodies through a lot. Injuries among runners are almost unavoidable if a person runs much, at all. Understanding your body’s limitations and building up your endurance before running long distances is key to avoiding injuries and...

learn more

Dr. Jeffery Kleis is a leading provider for podiatry and laser nail fungus treatments in Southern California. Located in Costa Mesa, CA, Dr. Kleis sees patients from throughout Orange County and Los Angeles County, as well as being sought regularly...

learn more

  Rheumatoid arthritis is a painful condition affecting more than a million Americans. Women are nearly three times more likely to get rheumatoid arthritis and the condition often leads to other problems in the body, as well. Rheumatoid arthritis...

learn more

Osteoarthritis is also called degenerative joint disease and is the most common form of arthritis. Osteoarthritis affects millions of people worldwide. While osteoarthritis occurs most commonly in the hands, knee, hips, and spine, it can affect any...

learn more

The skin is the body’s largest organ. It serves a vital purpose in protecting the body from the impurities that exist in the world around us. The skin is filled with special cells that protect the body from viruses bacteria and other threats. When...

learn more

Plantar fasciitis is a common condition, causing foot pain for more than 3 million people nationwide. Pain from plantar fasciitis occurs primarily in the heel of the foot and is described as a stabbing pain that usually occurs first thing in the...

learn more

Toenail fungus is a common condition, especially among athletes, older individuals, and people with compromised immune systems. Up to 10% of the population is estimated to suffer from toenail fungus infections. This condition is so common because...

learn more

Irritation and inflammation in your Achilles tendon could mean that you have Achilles tendonitis. Achilles tendonitis causes pain and can lead to a bone spur on the back of your heel bone. While this is an injury that most often occurs in athletes...

learn more