Posterior Tibial Tendon Dysfunction

  • Stage I (PTTD) includes tendinitis. There is inflammation of the tendon causing pain, discomfort. The tendon has not torn but this stage can still cause significant limitations.

  • There is a partial or complete tear of the tendon accompanied by a foot deformity. The foot is still flexible.

  • There is a partial or complete tear of the tendon accompanied by a foot deformity. The foot has developed degenerative and arthritic changes causing positional changes in the structure of the foot.

  • There is significant damage to the tendon accompanied by a foot deformity that has also lead to degenerative and adaptive changes to the architecture of the ankle.

Posterior tibial tendon dysfunction is a condition that occurs when the posterior tibial tendon, which runs along the inside of the ankle and foot, becomes damaged or weakened. This can lead to instability in the foot and ankle, and can eventually lead to deformity if left untreated. There are several stages of posterior tibial tendon dysfunction, which are determined by the severity of the condition and the level of damage to the tendon.

In the early stages of posterior tibial tendon dysfunction, patients may experience pain and swelling along the inside of the ankle and foot. This is often accompanied by a feeling of instability when standing or walking. At this stage, treatment may include rest, ice, and physical therapy to stretch and strengthen the tendon and supporting muscles.

If left untreated, the condition can progress to the intermediate stage. At this point, the pain and instability may become more severe, and patients may begin to notice changes in the shape of their foot. The arch of the foot may begin to flatten and the heel may start to turn inward, a condition known as "pronation." Treatment at this stage may include the use of orthotic inserts or braces to help support the foot and prevent further deformity.

In the advanced stages of posterior tibial tendon dysfunction, the foot and ankle may become severely deformed. The arch of the foot may become flat and the heel may turn inward significantly. Walking may become difficult and painful. At this point, surgery may be necessary to repair the damaged tendon and restore stability to the foot and ankle. Following surgery, a lengthy rehabilitation process is typically required to regain strength and mobility.

Posterior tibial tendon dysfunction is a progressive condition that can lead to significant deformity and disability if left untreated. Early diagnosis and treatment are key to preventing the condition from worsening. If you are experiencing pain and instability in your foot and ankle, it is important to seek medical attention from a qualified healthcare provider.

Stage I -Tendinitis

Staging often requires a combination of physical examination and imaging modalities (X-ray or MRI).