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What Is Posterior Tibial Tendon Dysfunction (PTTD)?   

The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in flattening of the foot.

PTTD is often called adult acquired flatfoot because it is the most common type of flatfoot developed during adulthood. Although this condition typically occurs in only one foot, some people may develop it in both feet. PTTD is usually progressive, which means it will keep getting worse, especially if it is not treated early.

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Causes

Overuse of the posterior tibial tendon is often the cause of PTTD. In fact, the symptoms usually occur after activities that involve the tendon, such as running, walking, hiking or climbing stairs.

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Symptoms

The symptoms of PTTD may include pain, swelling,

a flattening of the arch and an inward rolling of the

ankle. As the condition progresses, the symptoms

will change.

For example, when PTTD initially develops, there

is pain on the inside of the foot and ankle (along

the course of the tendon). In addition, the area may

be red, warm and swollen.

Later, as the arch begins to flatten, there may still be

pain on the inside of the foot and ankle. But at this

point, the foot and toes begin to turn outward and the ankle rolls inward.

As PTTD becomes more advanced, the arch flattens even more and the pain often shifts to the outside of the foot, below the ankle. The tendon has deteriorated considerably, and arthritis often develops in the foot. In more severe cases, arthritis may also develop in the ankle.

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