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Posterior Tibialis Tendon Dysfunction – What does it mean for me?

Newcastle Podiatry - Thursday, December 04, 2014

The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to support the arch while performing weight bearing activities particularly walking and running. Posterior tendon dysfunction (PTTD) is a condition characterised by tissue damage within the tendon that leads to deterioration of function and ultimately impairing its ability to support the arch, impeding daily living.

PTTD can initially manifest as pain, redness and swelling along the inside of the lower leg, medial ankle and arch. It is categorised into 4 stages of severity depending on strength, pain and foot posture deformity. It can commonly progress and be very debilitating with permanent structural damage a long term outcome. It can occur rapidly transforming a normal arched foot into a flat painful one. Factors contributing can include increased body weight, poor footwear or barefoot activities, a flattened foot posture or higher load activities such as forefoot based sports.

Clinical assessment by a trained podiatrist includes thorough assessment of gait patterns, footwear, physical activities and biomechanical assessment to help diagnose and dictate treatment options. Imaging through the form of x-ray, Ultrasound and MRI can also be useful tools to help establish severity and rule out differential diagnoses. Identifying underlying contributing factors is crucial to affective treatment. The overriding treatment is to take load away from the tendon and affected structures using prescription functional foot orthotics which ensure your feet work in their optimal position. Activity modification, anti-inflammatories and footwear changes, also play a role.

Due to the progressive nature of the condition, early intervention is advised. If correction is warranted at the foot, Orthotic therapy is an effective tool to unload the structure. Orthotics can help stop progression and prevent recurrence in both the short and long term ensuring a return to sport and daily living is comfortable.


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