Foot Pain – Posterior Tibial Tendon Dysfunction

Becky WatsonNovember 22, 2022

Posterior Tibial Tendon Dysfunction

The tibialis posterior muscle supports the foot arch, turns the foot inward, and points it downward. When the tendon is stressed, it can become inflamed or painful, which is known as posterior tibial tendon dysfunction (PTTD) or acquired adult flat foot.

Posterior Tibial Tendon Dysfunction - Foot Pain

Up to 10% of the population has posterior tibial tendon dysfunction (PTTD), which is more common in women aged 40-50. PTTD often occurs in people with flat feet, but the arch drops due to certain reasons. PTTD can be caused by trauma or overuse, and risk factors include obesity, diabetes, and inflammatory arthritis.

Symptoms of a flattened arch may include pain on the inside of the ankle and instep, inflammation, redness, and increased pain during physical activity. There are 4 stages of PTTD. Stage 1 the tendon is stretched, stage 2 the tendon has a partial tear and by stage 3 and 4 the ankle becomes stiff and fixed. Whether you can stand on tiptoe on the affected side is a sign of what stage the PTTD is at, by stage 2 this will be more difficult and painful and by stages 3 and 4 this is likely impossible.

Early treatment of PTTD is crucial in preventing its progression. Supportive lace-up shoes with a flat sole are important for treating PTTD. The addition of an orthotic insert to support the arch and relieve stress and stretch on the posterior tibialis tendon is beneficial. By stage 3 and 4 an ankle brace and potentially surgery may be required.

The insoles we recommend for posterior tibial tendon dysfunction are: PRIMO (1), POSA (2), PELUCHE (3), PROFILO (4), PURA (5) or PRECISO (6).