Posterior Tibial Tendon Dysfunction – Signs & Symptoms

The posterior tibial tendon is one of the primary supporting tendon of your foot which helps it to function when you walk. The posterior tibial tendon (or PTT) attaches the calf muscle to the bones of the foot. This tendon in foot supports the arch of the foot. Because of extreme usage, the tendon can become inflamed. Its sliding movement can get damaged resulting in inflammation, overstretching, gradual or total breaking of the tendon.

What is Posterior Tibial Tendon Dysfunction?

Posterior tibial tendon dysfunction is the swelling or tearing of the posterior tibial tendon; so that it is not able to provide the necessary strength and support for the arch of the foot.

PTTD usually occurs just underneath the prominence of the inner side of ankle at the end of the shin bone, the tibia. This part of the tendon exists in a “watershed zone” where the blood supply is weakest. Therefore, when PTTD happens the body has difficulty delivering the proper nutrients to that area for recovery.

The naturally acquired adult flatfoot disability is also referred to as posterior tibial tendon dysfunction and it is the very common kind of flatfoot that generally takes place during adult period. Frequently this sort of illness accumulates in just one foot of the patient. But there are cases which it happens equally in 2 feet. Remember, posterior tibial tendon dysfunction is normally intensifying in nature and just gets worse with time. So, it must be treated as quickly as possible.

What Causes PTTD?

Posterior tibial tendon dysfunction’s primary cause is the overuse of this tendon and generally affects those who play basketball, etc or activities such as walking, running, hiking, and climbing stairs.

What Are the Symptoms of PTTD?

Pain, inflammation, unsteady gait, flattening of the arch and inward rolling of the ankle are among the warning signs of such problems.

The tendon may get completely distorted and cause arthritis in the foot. This dysfunction progressively worsens with time.  So its treatment in initial stages is essential.

How Is PTTD Treated?

Non-surgical cures of PTTD include:

1.  Bone Support Equipments,

Operating doctors commonly recommends an ankle brace or a customized orthotic device which is based on patient’s footwear size for it will give assistance to the patient’s arch.

2.  Immobilization

A short-leg cast or boot could be generally put on so as to stop the motion of the affected foot of the patient and that the injured tendon will be totally healed.

3. Physiotherapy

Different kinds of physical therapies, including ultrasound therapy and workouts, are generally used to treat this condition.


Medicines that are categorized as Non-steroidal anti-inflammatory drugs or NSAIDs such as ibuprofen can help decrease or take away aches and inflammation mainly because of PTTD

5.  Shoe Customization

Adjusting or changing of footwear can be other means of providing assistance to the arch. There are special inserts that are advised by the medical doctors to use which can help out for the treatment of an injured posterior tibial tendon.

6. Other treatments

Of note, two important initial treatment options include both rest and ice.  Applying cold packs to the sore areas for 20 minutes at a time–up to four times per day can help reduce swelling.  As well, rest or simply switching to avoiding activities which worsen pain is an important first step.  Physical therapy and steroid injections are both options to consider discussing with your doctor.

Surgical Treatment:

If the patient doesn’t respond to non-surgical treatment well, or if the pain has been occurring for more than 6 months, he has to undergo surgery. The surgery involves removing the injured parts of the tendon, rectifying the tear, lengthening, cleaning and transfer of tendon. The recovery time after surgery will depend on the severity of the condition.  Typically, surgery is only considered after 6 months of failed conservative treatment.  There are various types of surgical procedures available to treat this condition.


Jason Turner writes on behalf of The Foot Specialis - - Podiatry clinic based in San Jose & Milpitas offers foot treatment for various foot problems.

One thought on “Posterior Tibial Tendon Dysfunction – Signs & Symptoms

  • June 27, 2012 at 7:56 pm

    Good post. Very informative. I am working on becoming a lower limb and foot speciality trainer and this was a great introductory article to PTTD.
    Kurtis McDermid 


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