Synergy Health Partners

Posterior Tibial Tendon Dysfunction (PTTD)

  • etitive activities like running or walking
  • Acute injuries such as falls or direct impact to the foot
  • Age-related wear and tear
  • Obesity, which places extra stress on the tendon
  • Medical conditions like diabetes and hypertension


  • Pain and swelling along the inside of the ankle and foot
  • Flattening of the foot arch (flatfoot)
  • Inward rolling of the ankle
  • Difficulty standing on tiptoes or uneven terrain
  • Pain that worsens with activity and improves with rest
  • Tenderness when touching the inside of the ankle


  • Physical Examination: Assessing pain, swelling, and the shape of the foot arch.
  • Imaging Tests: X-rays to check for changes in the foot structure, MRI or ultrasound to evaluate tendon damage.


  • Rest and Ice: Reducing activity and applying ice to decrease pain and swelling.
  • Medications: Anti-inflammatory drugs to manage pain and reduce inflammation.
  • Orthotic Devices: Custom insoles or braces to support the arch and relieve stress on the tendon.
  • Physical Therapy: Exercises to strengthen the posterior tibial tendon and improve flexibility.
  • Immobilization: Using a walking boot or cast to allow the tendon to heal.
  • Surgery: In severe cases, surgical intervention may be needed to repair or reconstruct the tendon and correct foot alignment.

Prognosis: With appropriate treatment, many individuals with PTTD can experience significant improvement in symptoms and function. Early intervention is crucial to prevent the progression of the condition and avoid permanent foot deformity. Maintaining a healthy weight, wearing supportive footwear, and adhering to recommended treatments can help manage PTTD and prevent recurrence.