Posterior Tibial Tendon Dysfunction (PTTD)

Adult Acquired Flatfoot Treatment at Edge Podiatry

At Edge Podiatry, we specialize in diagnosing and treating Posterior Tibial Tendon Dysfunction (PTTD), one of the most common causes of adult-acquired flatfoot and progressive arch collapse.

PTTD occurs when the posterior tibial tendon, a critical structure that supports the arch of the foot, becomes inflamed, weakened, or partially torn. As the tendon loses function, the arch begins to collapse, leading to flatfoot deformity, instability, and pain.

What Is PTTD?

The posterior tibial tendon plays a vital role in:

• Supporting the arch of the foot

• Stabilizing the ankle during walking

• Controlling foot alignment and motion

When this tendon is injured or overworked, it can no longer properly support the foot. Over time, this leads to a progressive flattening of the arch, often referred to as adult acquired flatfoot deformity.

Symptoms of PTTD

Patients with PTTD commonly experience:

• Pain along the inside of the ankle or arch

• Swelling on the inner side of the foot

• Flattening of the arch over time

• “Rolling in” of the ankle (overpronation)

• Pain that shifts to the outside of the foot in later stages

• Difficulty standing, walking, or staying active for long periods

PTTD is typically progressive, meaning symptoms worsen if left untreated.

Causes and Risk Factors

PTTD is most often caused by overuse and stress on the tendon, but several factors can increase risk, including:

• Flat feet or excessive pronation

• Obesity

• Previous foot or ankle injuries

• Aging (more common in adults, especially women)

• High-impact activities or prolonged standing

Treatment Options

At Edge Podiatry, we focus on early, non-surgical treatment whenever possible to prevent progression of deformity.

Conservative Treatment Options:

• Custom orthotics to support the arch and reduce tendon stress

• Bracing or ankle support devices

• Activity modification

• Anti-inflammatory medications

• Physical therapy and strengthening programs

• Stretching and gait correction

Advanced Treatment Options:

In more advanced or painful cases, treatment may include:

• Immobilization in a walking boot

• Regenerative treatments (when appropriate)

• Surgical repair of the tendon

• Reconstructive procedures to restore arch alignment

Surgery is typically reserved for cases where conservative care does not provide adequate relief or when deformity continues to progress.

Why Early Treatment Matters

PTTD is a progressive condition, meaning early intervention is key. Without treatment, the condition can lead to:

• Permanent flatfoot deformity

• Chronic pain and instability

• Arthritis in the foot and ankle joints

• Decreased mobility and activity level

Schedule an Evaluation

If you are experiencing arch pain, ankle swelling, or worsening flatfoot deformity, contact Edge Podiatry today.

Early diagnosis and treatment of PTTD can help preserve foot function, reduce pain, and prevent long-term deformity.