Posterior Tibial Tendon Dysfunction

What You Need To Know About PTTD

Understanding how PTTD develops, what to look for, and how we treat it.

Understanding Posterior Tibial Tendon Dysfunction

Posterior Tibial Tendon Dysfunction (PTTD) is a condition that affects the tendon responsible for supporting the arch of the foot. When this tendon becomes inflamed, stretched, or torn, it can cause pain, instability, and even flatfoot deformity.

The posterior tibial tendon runs along the inside of the ankle and foot, helping support the arch. When it weakens or fails, the arch may collapse, leading to flatfoot. This condition often worsens over time if left untreated.

Common symptoms include pain and swelling along the inside of the ankle, loss of arch height, difficulty standing on tiptoes, weakness and instability when walking, and outward rolling of the ankle. PTTD is often caused by overuse from repetitive activities such as running or walking, acute injuries like falls or ankle sprains, degenerative changes due to aging, obesity, or chronic inflammatory conditions such as arthritis.

At the Foot Care Center, diagnosis may involve a physical examination to assess arch support and tendon strength, X-rays to evaluate foot alignment, and MRI or ultrasound to check for tendon inflammation or tears. If you are experiencing persistent ankle pain or signs of flatfoot, our team can evaluate the tendon and recommend a treatment plan tailored to your condition.

Treatment Options and Why Early Care Matters

At the Foot Care Center, we provide diagnosis and treatment for PTTD in Billings, MT and to help patients restore function and reduce pain. We treat PTTD with both conservative and surgical methods, and our team provides customized treatment plans to relieve pain, restore arch function, and prevent further complications.

Non-surgical treatments include rest, ice, compression, and elevation (RICE), anti-inflammatory medications, custom orthotics or ankle-foot orthoses (AFO) for arch support, immobilization with a walking boot or cast, and physical therapy to strengthen the tendon and surrounding muscles.

For advanced cases of PTTD, surgery may be recommended. Surgical options include debridement or repair of the posterior tibial tendon, tendon transfer to restore arch support, osteotomy (bone realignment) for severe flatfoot, and fusion procedures for advanced deformity or arthritis.

When PTTD is left untreated, patients may develop progressive flatfoot deformity, chronic pain and swelling, severe ankle instability, and arthritis in the ankle and foot joints. Seeking care early gives the tendon the best chance to heal with conservative measures and helps patients avoid more involved procedures down the road.