Posterior Tibial Tendon Dysfunction (PTTD) is a condition that affects the posterior tibial tendon, a key structure that supports the arch of the foot and helps maintain proper foot alignment while walking. When this tendon becomes inflamed, weakened, or torn, it can lead to flatfoot deformity, pain along the inside of the ankle, and difficulty walking or standing for long periods.

Causes of PTTD

PTTD typically develops due to:

• Overuse or repetitive strain, especially from running, walking, or standing for long periods
• Injury or trauma to the tendon
• Age-related degeneration of the tendon
• Chronic medical conditions such as diabetes, obesity, or hypertension
• Flat feet or biomechanical abnormalities that place extra stress on the tendon

Symptoms of PTTD

Patients with PTTD may notice:

• Pain and swelling along the inside of the ankle and foot
• Flattening of the arch over time
• Difficulty walking or standing on tiptoe
• Progressive foot and ankle weakness
• Pain that worsens with activity and improves with rest

Diagnosis

At Longwood Foot Clinic, our podiatrists perform a thorough physical exam to assess tendon function and foot alignment. Imaging such as ultrasound, MRI, or X-rays may be used to determine the severity of tendon damage and rule out other conditions.

Treatment Options

Treatment depends on the severity of PTTD and may include:

Non-surgical management:

• Rest, activity modification, and anti-inflammatory therapy
• Supportive footwear and custom orthotics to correct foot alignment
• Physical therapy to strengthen the tendon and improve flexibility
• Bracing or walking boots to immobilize and protect the tendon

Surgical treatment:

• Considered for severe cases or when conservative care fails
• Procedures may repair, reinforce, or reconstruct the posterior tibial tendon and restore proper foot function

Early diagnosis and treatment are essential to prevent progressive deformity and maintain mobility.

If you are experiencing pain along the inside of your foot or ankle, flattening arches, or difficulty walking, contact Longwood Foot Clinic, your trusted podiatrist in Ilford, to schedule a consultation and receive a personalised treatment plan for PTTD.