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Posterior Tibial Tendon Dysfunction (PTTD) Treatment
When the arch of the foot begins to collapse and ankle pain sets in, the cause may be deeper than it seems. At Integrity Foot and Ankle, we diagnose and treat posterior tibial tendon dysfunction (PTTD)—a progressive condition where the tendon supporting the arch becomes inflamed or torn. This tendon plays a critical role in foot stability, and when it’s compromised, it can lead to a flatfoot deformity and chronic discomfort if not addressed early.
PTTD often starts with mild pain along the inner ankle or foot, especially after physical activity. Without intervention, symptoms can worsen, making it difficult to stand, walk, or wear regular shoes comfortably. Our team offers tailored, step-by-step care to support healing, relieve pain, and restore the integrity of the foot’s structure—whether through conservative methods or surgical correction when needed.
Benefits of PTTD Treatment
- Reduces pain and inflammation along the inner ankle and foot
- Supports and restores the natural arch structure
- Prevents the progression of flatfoot deformity
- Improves stability and balance during walking or standing
- Restores tendon function and overall foot mechanics
- Offers both non-surgical and surgical treatment paths
- Helps patients return to regular activity with less discomfort
- Customized orthotic support designed for long-term relief
- Minimizes the risk of long-term joint and tendon damage
- Improves quality of life through personalized foot care
Treatment Options for Posterior Tibial Tendon Dysfunction
Non-Surgical Approaches
Rest, Ice, and Anti-Inflammatory Medication
Reducing activity and applying ice can help control inflammation in early stages. Nonsteroidal anti-inflammatory medications (NSAIDs) may be recommended to reduce pain and swelling.
Custom Orthotics and Ankle Bracing
Orthotic inserts support the arch and improve foot alignment, while ankle braces provide added stability during movement. Both are especially effective in early or moderate cases of PTTD.
Physical Therapy
Targeted exercises strengthen the foot and ankle muscles, improving tendon function and mobility. Therapy may include stretching, balance work, and gait training to support recovery.
Surgical Options
Tendon Repair or Transfer
In cases where the posterior tibial tendon is torn or severely damaged, surgical repair or replacement with a nearby tendon can restore function. This approach aims to preserve the arch and correct instability.
Flatfoot Reconstruction
When significant arch collapse has occurred, a combination of tendon procedures and bone realignment may be required. This complex surgery is customized based on the extent of deformity and joint involvement.
What to Expect Before and After Treatment
Before Treatment
- Physical exam focused on foot alignment and tendon strength
- Imaging (X-rays, MRI, or ultrasound) to evaluate tendon condition
- Discussion of symptoms, activity level, and treatment preferences
- Fitting for orthotics or brace (if applicable) and pre-surgical planning (if needed)
After Treatment
- If non-surgical: gradual return to activity with bracing or orthotic support
- If surgical: recovery includes a period of immobilization, followed by physical therapy
- Regular follow-ups to assess healing, foot function, and prevent recurrence
- Guidance on footwear, ongoing support, and long-term care strategies
FAQ
What causes posterior tibial tendon dysfunction?
PTTD often develops from overuse, repetitive strain, or injury to the tendon. Age-related degeneration, obesity, and flatfoot conditions can also contribute to its progression.
What are the early signs of PTTD?
The earliest symptoms include pain along the inner ankle or arch, swelling, and difficulty standing on tiptoes. As the tendon weakens, the arch may begin to flatten, and walking may become uncomfortable.
Can posterior tibial tendon dysfunction be reversed?
In its early stages, PTTD symptoms can be managed and often improved with conservative treatment. Advanced cases may require surgery to restore structure and function.
How long is recovery after PTTD surgery?
Recovery time varies depending on the type of surgery but generally ranges from several weeks to a few months. Patients will follow a rehabilitation plan that includes rest, physical therapy, and gradual return to weight-bearing activity.
What happens if PTTD goes untreated?
Without treatment, PTTD can lead to progressive flatfoot deformity, chronic pain, and joint damage. Early intervention is key to preserving mobility and avoiding more complex procedures.
