Flatfoot is a condition that affects many people, and Posterior Tibial Tendon Dysfunction (PTTD) is the most common type of flatfoot developed during adulthood. The posterior tibial tendon is one of the major supporting structures of the foot, helping it to function correctly while walking. Changes to the tendon can cause impairment to its ability to support the arch, resulting in flattening of the foot.
PTTD is generally caused by overuse of the posterior tibial tendon. Symptoms usually occur after activities that involve the tendon, such as running, walking, hiking, or climbing stairs. The symptoms of PTTD include pain, swelling, a flattening of the arch, and an inward rolling of the ankle. If left untreated, PTTD will become progressively worse.
It is essential to treat PTTD early to avoid painful arthritis in the foot and ankle and increasing limitations on walking, running, or other activities. Early treatment can help to arrest the progression of the disease, and the symptoms may resolve without the need for surgery.
Non-surgical treatment options for PTTD include orthotic devices or bracing, immobilization, physical therapy, medications, and shoe modifications. Your foot and ankle surgeon may provide a custom orthotic device that fits into your shoe or advise changes to make with your shoes and provide special inserts designed to improve arch support. Ultrasound therapy and exercises may help rehabilitate the tendon and muscle following immobilization. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen can help reduce the pain and inflammation.
In cases of PTTD that have progressed substantially or have failed to improve with non-surgical treatment, surgery may be required. For some advanced cases, surgery may be the only option. Your foot and ankle surgeon will determine the best approach for you.
If you are experiencing pain or swelling in your foot and ankle or notice a flattening of your arch, seek medical advice immediately. Dr. Gilbert Huang, DPM is an expert in the treatment of PTTD and offers both non-surgical and surgical approaches to treat the condition. Don’t let PTTD limit your activities or cause you more pain; schedule an appointment with Dr. Gilbert Huang, DPM today!