Posterior Tibial Tendon Dysfunction (PTTD)

One of the worst kinds of flat foot is due to the weakening or rupture of a tendon called the posterior tibialis. The condition is known by several names including posterior tibialis dysfunction (PTTD), posterior tibial tendon dysfunction and tibialis posterior dysfunction. The weakening of this tendon leads to an “Adult Acquired Flatfoot” – a progressive flattening of one or both feet.

​

This condition can lead to severe changes in foot position and function. The collapse of the arch can lead to arthritis, ankle pain, foot pain, fatigue, tendon pain and changes in shape of the foot. It can even cause knee, hip and back pain due to changes in gait.

​

We can usually treat PTTD with conservative treatment, and surgery is rarely indicated. It is important, however, to be seen as soon as possible for a complete evaluation to help prevent damage to the foot.

​

Most PTTD is treated long-term with orthotic devices. Very specialized orthotics with special features designed to offer greater control than standard orthotics are often needed. Standard orthotic devices usually fail in treating PTTD. Sometimes orthotics cannot provide enough control and in those cases we prescribe Ankle-Foot Orthotics (AFOs) and/or shoe modifications for greater control and pain relief.