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Martin Foot & Ankle

Posterior Tibial Tendon Dysfunction

There’s a saying that declares you’re only as strong as your weakest link. Sometimes that is very true for your body. While some structures are able to compensate for a loss of strength or support, many times a weakened tendon destabilizes an entire portion of the body. You see this in the feet when you develop posterior tibial tendon dysfunction.

Little Tendon, Big Impact

You have multiple structures that hold up your arch, stabilize the foot, and help you walk normally. One of the most important tendons involved in all three of these functions is the posterior tibial tendon. It stretches down from a muscle in your lower leg, behind the bump on the inside of your ankle, then around and underneath the arch. Posterior tibial tendon dysfunction (PTTD) develops when something injures this tissue—either stress from overuse or a tear from trauma. As the problem progresses, it can result in fallen arches. The result can include problems such as adult acquired flatfoot.

The most common cause of PTTD is overuse, so the discomfort tends to increase when you’re active and decrease when you rest. Typically you feel the pain along the inside of the foot and ankle, especially at first. This area may swell somewhat, and the arch may flatten. This can lead to an inward rolling of the arch and ankle. The flatter the arch becomes, the worse the pain gets. Often the outside of the foot becomes uncomfortable as well. In severe cases, arthritis may develop in the ankle from the strain. Whether an overuse problem or a traumatic tear, PTTD needs to be addressed to prevent chronic pain and weakness.

Re-stabilizing the Foot

The sooner problems with the posterior tibial tendon are discovered and treated, the greater your chances of successfully remedying them. This is especially true for conservative treatment. Many cases can be managed using entirely noninvasive methods if caught early. Our expert podiatry staff here at Martin Foot and Ankle can use diagnostic tests and images to identify the issue and determine its extent. Then we can advise you about your best treatment options.

Reducing inflammation and allowing the tendon time to rest are key to restoring the lower limbs. You’ll need to take a break from your activities for a time so that you don’t continue to strain the tissue. You may need to wear a brace or special boot to immobilize the affected foot. This will ensure it can rest-- stress-free. Icing the foot and ankle help lower swelling and decrease inflammation. We may recommend various anti-inflammatory medications as well to help with the discomfort. As your foot recovers, you may need orthotics to stabilize and support the correct function. Physical therapy can help rebuild your foot strength over time so that the tendon is able to do its job correctly again. If the problem doesn’t respond to noninvasive care, or is badly torn, you may need surgery to correct the issue.

Posterior tibial tendon dysfunction can cause a range of painful problems that limit your mobility. If you don’t address them soon enough, they could degenerate into chronic issues. A little intentional care can go a long way in restoring and protecting your lower limbs. Don’t take your feet for granted or ignore foot pain. Contact the Martin Foot and Ankle podiatrists in York, Hanover, Lititz and Lancaster, PA, for an appointment or more information. Call (717) 757-3537, or use the website contact form to reach us.