Region: Foot-Ankle
Posterior Tibial Tendon Dysfunction (PTTD) occurs when long-lasting inflammation of the tibial tendon, the tendon that runs along the arch of the foot, causes the tendon to break down. As it weakens, it can no longer support the foot causing it to flatten and the ankle to turn inward.
What is Posterior Tibial Tendon Dysfunction?
Posterior Tibial Tendon Dysfunction (PTTD) occurs when long-lasting inflammation of the tibial tendon, the tendon that runs along the arch of the foot, causes the tendon to break down. As it weakens, it can no longer support the foot causing it to flatten and the ankle to turn inward.
Symptoms
- Pain along the arch of the foot or the inside of the foot or ankle that starts gradually
- Tenderness to touch along the inside or the arch of the foot or in the ankle
- Swelling along the path of the tendon, especially in the inner ankle
- Weakness in the foot or ankle, especially when "pushing off"
- A collapsed arch (flat foot)
- The ankle rolls inward
- The heel or/and toes turn outward
What does Posterior Tibial Tendon Dysfunction feel like?
- Aching pain along the inner foot or ankle that starts gradually and worsens over time
- Pain gets worse during activity like jumping, running, or walking/standing for long periods of time
- Feeling weakness in the arch of the foot, especially when walking or standing
- Stiffness
- Walking may feel awkward or unstable
What are common causes of Posterior Tibial Tendon Dysfunction?
- Repetitive strain injuries caused by activites such as working out too hard without warming up or cooling down or sports that require using the same motion repeatedly
Self check
- Is there pain along the arch of the foot, inner foot, or ankle?
- Is there weakness in the foot or ankle?
- Does the foot appear flat?
- When walking, does the ankle turn inward?
Educational only — not a medical diagnosis.
What to do now
- Rest and decrease repetitive activities such as running and jumping
- Ice the affected area for short intervals
- Elevate affected foot
- For more severe cases, wearing a cast or boot may be required
Red flags
- Pain becomes constant
- Pain worsening over time
- Sharp pain develops
- Difficulty or inability to stand on tiptoe on the affected foot
Recovery tips
- Avoiding repetitive motions during the time of recovery prevents further damage to the tendon
- Extended periods of standing or walking can strain the inflamed tendon, so minimize as much as possible
- Performing exercises to help strengthen the tendon and its supporting structures
Educational only. Not a medical diagnosis.