Posterior tibial tendon dysfunction or PTTD is one of the most common problems of the foot and ankle. PTTD occurs when the posterior tibial tendon becomes inflamed, partially torn or even ruptured. As a result, the tendon may not be able to provide stability and support for the arch of the foot, resulting in flatfoot. The posterior tibial (PT) tendon serves as one of the major structures for walking. The PT tendon provides strength, stability and supports the arch of the foot.

PTTD typically affected middle age adults and female more than men. It is also called adult acquired flat foot. PTTD is the most common cause of acquired flat feet during adulthood. The disease is usually progressive and worsens over the years.

The major cause of PTTD is overuse of the PT tendon or pronation. Overweight and trauma can be a major contributor as well. Symptoms include pain, swelling, inward rolling of your ankle, and flatfoot. As PTTD becomes more advanced, the arch flattens even more and the pain often shifts to the outside of the foot, below the ankle. Due to the poor position of the foot and ankle joints, you are prone to developing arthritis as well.

Most patients can be treated without surgery, using orthotics and braces. If orthotics and braces do not provide relief, surgery can be an effective way to help with the pain. Surgery might be as simple as removing the inflamed tissue or repairing a simple tear. Advanced tissue grafts can significantly reduce swelling and increase healing as well. Patients will require aggressive physical therapy with or without surgery to improve function and recover strength.