Posterior Tibial Tendon Dysfunction (PTTD) is a condition affecting the tendon that supports the arch of your foot. This dysfunction occurs when the posterior tibial tendon, which runs along the inner side of the ankle, becomes inflamed or torn. Left untreated, PTTD can lead to a collapsed arch, flat feet, and persistent pain, making it difficult to walk or stand comfortably.
What is Posterior Tibial Tendon Dysfunction?
PTTD affects the posterior tibial tendon, which plays a crucial role in stabilising and supporting the arch of the foot. When this tendon weakens or tears, it struggles to support the arch properly, causing the foot to flatten over time. The condition is commonly seen in middle-aged adults, particularly women, but can affect anyone, especially those who are overweight or lead an active lifestyle that places stress on the feet.
Symptoms of Posterior Tibial Tendon Dysfunction
The symptoms of PTTD often begin subtly but can worsen over time if untreated. Key symptoms include:
- Pain and Swelling: Discomfort along the inner side of the ankle or foot, especially after physical activities.
- Flattening of the Arch: A noticeable flattening of the arch in one or both feet.
- Difficulty Walking or Standing: Pain can worsen with activity, making it hard to stand for long periods or walk comfortably.
- Rolling of the Ankle: As the arch collapses, the ankle may roll inward, creating a misalignment.
Causes and Risk Factors
Several factors can contribute to the development of PTTD, including:
- Overuse or Injury: High-impact activities or an injury to the foot can strain the posterior tibial tendon.
- Ageing: The risk of PTTD increases with age as tendons naturally weaken.
- Obesity: Excess weight puts additional pressure on the tendon, increasing the likelihood of dysfunction.
- Chronic Conditions: Conditions like hypertension or diabetes can weaken tendons over time, making them more prone to damage.
Diagnosing Posterior Tibial Tendon Dysfunction
A podiatrist will examine your foot to assess pain, tenderness, and any changes in the arch. Imaging tests such as X-rays, ultrasounds, or MRIs can help determine the extent of the damage and rule out other potential causes of foot pain.
Treatment Options for Posterior Tibial Tendon Dysfunction
Treatment for PTTD depends on the severity of the condition. Early intervention can help manage symptoms and prevent further progression. Common treatments include:
- Rest and Immobilisation: Resting and avoiding activities that place stress on the tendon allows it time to heal. In severe cases, a cast or boot may be used to immobilise the foot.
- Orthotic Devices: Custom orthotics or ankle braces can provide extra support to the arch, alleviating strain on the tendon and reducing pain.
- Physical Therapy: Specific exercises can help strengthen the muscles around the posterior tibial tendon, improving stability and supporting the arch. Stretching exercises can also enhance flexibility.
- Medications: Anti-inflammatory medications can help manage pain and reduce swelling, allowing for greater comfort during recovery.
- Surgical Intervention: If conservative treatments are ineffective, surgery may be required. Surgical options may include tendon repair, reconstruction, or realignment to restore function and relieve pain.
Preventing Posterior Tibial Tendon Dysfunction
While not all cases of PTTD can be prevented, there are steps you can take to reduce your risk:
- Maintain a Healthy Weight: Reducing excess weight can ease strain on your tendons and help support foot health.
- Wear Supportive Footwear: Choose shoes with good arch support and avoid wearing high heels or unsupportive flats for extended periods.
- Strengthen Your Feet and Ankles: Regular strengthening exercises for the feet and ankles can enhance stability and reduce the likelihood of tendon strain.
Conclusion
Posterior Tibial Tendon Dysfunction is a painful and progressive condition that, if left untreated, can lead to long-term foot deformities. Recognising the symptoms early and seeking podiatric advice is crucial for effective treatment and recovery. If you’re experiencing foot pain or have noticed changes in your arch, consult Louisa Seymour Podiatry for a professional assessment and treatment plan to restore comfort and mobility.
