Posterior Tibial Tendon Dysfunction (PTTD)

Posterior Tibial Tendon Dysfunction (PTTD) is a common cause of arch pain. The tibialis posterior muscle is located in the calf and runs along the tibia and fibula. The muscle has a long tendon which connects into the arch of the foot. This is known as the tibialis posterior tendon.
The main function of the tibialis posterior muscle and its tendon is to control the speed at which the foot pronates during gait. It therefore experiences very high forces when walking and running. PTTD is the medical term to describe when the tendon becomes inflamed and damaged. It is also known a tibialis posterior tendinopathy.
Early treatment of PTTD is the key to prevent significant damage to the tendon occurring. In the early stages of the condition PTTD responds well to conservative management such as physiotherapy and Orthotics.

Signs and Symptoms of PTTD

Pain in the arch and/or shin. This pain normally increases with activity. It normally only occurs in one foot.
Pain on palpation of the tibialis posterior tendon.
Unable to perform single heel lift of effected side.
“Too many toes” sign.


Treatment of PTTD is dependent on the extent of damage to the tendon. If you suspect you have PTTD it is important to have this diagnosed and treated by a health care professional. If left untreated PTTD can process into a serious foot problem which may require surgery.
In the early stages PTTD may be treated with a physiotherapy program to strengthen the posterior tibial tendon and improve ankle mobility.
Foot Orthotics are also often used to treat PTTD. Orthotics can offload the tendon to decrease pain and to prevent the tendon from becoming damaged further. If moderate damage to the tendon has occurred Foot Orthotics may be essential to stop the damage from worsening.

Whether you are struggling with pain, having issues with mobility or training for a sporting event we will endeavour to find the best treatment to meet your individual needs and expectations.

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