Posterior Tibial Tendon Dysfunction
The tibialis posterior muscle plays an important role in supporting the main arch of the foot, turning the foot inwards and pointing it downwards. The tibialis posterior tendon runs down the inside of the ankle and inserts under the foot. Anything that causes an increased load or stress on the tendon can cause it to become inflamed and painful. This is known as posterior tibial tendon dysfunction (PTTD), tibialis posterior tendinopathy or acquired adult flat foot.
It is a common condition affecting up to 10% of the population, however it is most common in women aged between 40-50. Most often people who develop PTTD are flat footed to begin with, but something happens to cause the arch to drop further. PTTD can be caused by a trauma or overexertion. Additional risk factors include obesity, diabetes and inflammatory arthritis.
Along with an increased flattening of the arch, symptoms may include pain on the inside of the ankle and instep, inflammation and redness and increased pain on exertion. There are 4 stages of PTTD. Stage 1 the tendon is stretched, stage 2 the tendon has a partial tear and by stage 3 and 4 the ankle becomes stiff and fixed. Whether you can stand on tip toe on the affected side is a sign of what stage the PTTD is at, by stage 2 this will be more difficult and painful and by stage 3 and 4 this is likely impossible.
PTTD is best treated early to prevent progression. Supportive lace up shoes with a flat sole are important for treating PTTD. The addition of an orthotic insert to support the arch and relieve stress and stretch on the posterior tibialis tendon is beneficial. By stage 3 and 4 an ankle brace and potentially surgery may be required.
Would you like to know more about common foot pain problems before making a choice? You may find one of the following blog articles useful:
Achilles Tendonitis Click here to read our ‘Foot Pain – Achilles Tendonitis?’ blog to find out more.
Diabetic Neuropathy Click here to read our ‘Foot Pain – Diabetic Neuropathy?’ blog to find out more.
Posterior Tibial Tendon Dysfunction Click here to read our ‘Foot Pain – Posterior Tibial Tendon Dysfunction?’ blog to find out more.
Tarsal Tunnel Syndrome Click here to read our ‘Foot Pain – Tarsal Tunnel Syndrome?’ blog to find out more.