Posterior Tibial Tendon Dysfunction

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Foot & Ankle Conditions

Foot & Ankle Physicians

Joshua C. Luginbuhl
Alan S. Tuckman

Posterior tibial tendon dysfunction, or PTTD, is a common problem of the foot and ankle.

The posterior tibial tendon is an extension of the tibialis posterior muscle that runs down the back of the calf. The tendon runs under the ankle bone on the inside of the foot, across the instep, and into the bottom of the foot. It supports the arch of the foot and helps turn the foot inward when we walk.

PTTD is a chronic problem that may be caused by overuse or an abnormality of the posterior tibial tendon. It is one of the leading causes of flat feet among adults, particularly in women over the age of 50. Although it usually develops in only one foot, it can occur in both feet.

The signs and symptoms of posterior tibial tendon dysfunction include:

  • Tenderness in the middle part of the foot
  • Arch collapse and flat foot on the affected side
  • Pain and swelling on the inside of the ankle
  • Foot and ankle weakness
  • Difficulty standing on your toes
  • Pain that develops gradually on the outside of the foot or ankle

If you suspect you may have PTTD, schedule an appointment with the foot and ankle team at Lancaster Orthopedic Group. Conservative treatments include rest, ice, compression, elevation or immobilization of the foot, and anti-inflammatory medications. Physical therapy may also help rehabilitate the tendon. Advanced cases of posterior tibial tendon dysfunction often require surgical procedures to straighten the foot and elevate the arch.

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