What is PTTD

01 Aug What is PTTD

Posterior Tibialis Tendon Dysfunction

At Shuman Podiatry and Sports Medicine, we know that your feet take a beating every day, and sometimes they fight back.

Fungal Nail, Ingrown Nail, and Other Troubles

If you have an ingrown nail, fungal nail, Achilles tendonitis, hammertoe or posterior tibialis tendon dysfunction (PTTD), the subject of this post, you’re probably not enjoying life to the fullest.


Also known as adult acquired flatfoot, PTTD is a serious condition. As it progresses, it will make your feet and ankles roll uncontrollably inward or outward. Left untreated, it can cause permanent damage to your foot and ankle.
The Posterior Tibial Tendon

The posterior tibial tendon is one of the most important ligaments in your foot. This tendon keeps your foot stable when you push or lift off the ground. It connects your calf to the middle part of your foot.

When it’s overused or stressed, the posterior tibial tendon can start to degrade. Over time, repeated stress will wear it down further and eventually lead to a rupture.

The causes of PTTD are not fully known. But some likely factors include:

  • obesity;
  • overuse;
  • history of steroid use;
  • previous foot trauma;
  • history of inflammatory diseases;
  • high blood pressure.


Symptoms of PTTD

  • Burning pain in the tendon area.
  • Redness and swelling of the ankle.
  • Pain that extends into your shins.
  • Visibly flattened arches.
  • Inability to stretch or lift your heels.



Because the symptoms of PTTD are similar to those of Achilles tendonitis, shin splints, and other podiatric conditions, the right diagnosis is key. Shuman Podiatry has the most innovative diagnostic tests. As with any foot injury, only the right diagnosis can lead to the right foot care.



Dr. Shuman can prescribe a treatment protocol that will allow your tendon to heal and prevent further injury. The treatment will probably include the following recommendations.

  • If you are running or doing other physically stressful activities, stop.
  • Use stretching exercises to strengthen the posterior tibia.
  • Wear custom orthotics to support the foot and balance your gait.
  • In some cases, complete immobilization of the foot is necessary.
  • Icing and pain medications can ease the pain.


Is Surgery Necessary?

Surgery is only necessary if other methods don’t work or if the PTTD has progressed to the point where surgery is the only option. Your podiatrist is the best person to determine the correct course of treatment.

If you do need surgery, make sure to follow the rehabilitation program outlined by your foot doctor or physical therapist.


Follow-Up Foot Care

  • Return to physical activity slowly and carefully.
  • Ask your podiatrist if you can return to running or other high-impact sports.
  • You may have to continue wearing custom orthotics and supportive shoes.
  • Practice careful, daily stretching of the tendon.


Call Shuman Podiatry

Foot and ankle pain won’t go away if you ignore them. In fact, they’ll just get worse and make it hard for you to do all the things you enjoy.

If you’re experiencing any symptoms that worry you, call your Loudoun County podiatrist and set up an appointment. We’ll get you back on the road to good foot health.

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