The posterior tibial tendon is one of the most important structures in your foot—it supports your arch and helps you walk, run, and stay balanced. When this tendon becomes damaged or inflamed, it can no longer support the foot properly, leading to posterior tibial tendon dysfunction (PTTD), sometimes called adult-acquired flatfoot.

At Premier Podiatry, we see how PTTD can progress from mild discomfort to significant mobility problems if left untreated. Understanding the causes, symptoms, and treatment options is key to protecting your long-term foot health.

What Is Posterior Tibial Tendon Dysfunction?

PTTD occurs when the posterior tibial tendon becomes stretched, inflamed, or torn. Over time, this weakens the arch, leading to progressive flattening of the foot.

Common Causes of PTTD

Several factors can contribute to this condition, including:

• Overuse – Common in athletes or those on their feet all day

• Injury – A fall, twist, or ankle sprain can damage the tendon

• Age-related changes – Tendons naturally weaken over time

• Inflammatory conditions – Such as rheumatoid arthritis

• Excess weight – Adds strain to the tendon and arch

Symptoms to Watch For

PTTD often starts gradually and worsens if not addressed. Signs may include:

• Pain and swelling along the inside of the ankle

• Arch collapse or flattening of the foot over time

• Difficulty standing on tiptoes on the affected side

• Rolling of the ankle inward (overpronation)

• Pain that worsens with activity and improves with rest

How We Diagnose PTTD

At Premier Podiatry, diagnosis begins with a thorough physical exam, review of your medical history, and gait analysis. In-house imaging—such as digital X-ray or diagnostic ultrasound—may be used to confirm the extent of tendon damage.

Treatment Options

The earlier PTTD is treated, the better the outcome. Non-surgical treatment may include:

• Custom orthotics to support the arch and reduce strain

• Supportive footwear to improve alignment and stability

• Bracing for additional ankle support

• Physical therapy to strengthen surrounding muscles

• Anti-inflammatory medication to reduce pain and swelling

If the condition is severe or non-surgical care isn’t effective, surgical intervention may be recommended to repair or reconstruct the tendon and restore arch support.

The Importance of Early Care

Left untreated, PTTD can lead to permanent arch collapse and arthritis in the foot and ankle. Seeking care at the first sign of symptoms can help preserve mobility and prevent long-term complications.

At Premier Podiatry, our team provides comprehensive care for posterior tibial tendon dysfunction, from early diagnosis to personalised treatment plans. Our goal is to reduce pain, restore function, and keep you moving comfortably.

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📞 Call (309) 838-8823 to schedule your consultation today.