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Posterior Tibial Tendon Dysfunction (PTTD): Causes, Symptoms, and Treatment Options

What is Posterior Tibial Tendon Dysfunction (PTTD)?

Posterior tibial tendon dysfunction (PTTD) is a condition in which the posterior tibial tendon, which helps support the arch of the foot, becomes inflamed or torn. This condition can lead to flatfoot deformity and pain on the inside of the ankle and foot.

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Symptoms

  • Pain and swelling along the inside of the ankle and foot

  • A visible flattening of the arch of the foot

  • Pain that worsens with activity, especially walking or standing

  • Weakness and difficulty standing on tiptoes

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Risk Factors

  • Obesity: Extra weight increases stress on the posterior tibial tendon

  • Overuse: Common in athletes and individuals who stand for long periods

  • Previous ankle injuries: Increase the risk of developing PTTD

  • Age: More common in middle-aged and older adults

  • Diabetes and Hypertension: Contributing to tendon degeneration

 

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Treatment

  • Rest and Activity Modification: Reducing activities that strain the tendon

  • Orthotics: Custom shoe inserts to support the arch and reduce pain

  • Physical Therapy: Strengthening exercises for the foot and ankle muscles

  • Ultrasound-Guided Steroid Injections: Reducing inflammation and pain in the posterior tibial tendon

  • PRP Therapy: Promoting tendon healing using the body’s natural growth factors

  • Hyaluronic Acid Injections: Providing additional cushioning to reduce pain and improve foot function

 

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