The posterior tibial tendon is one of the major supporting structures of the foot. It runs down the back of your leg, along the inner part of your ankle and continues under your foot to help support your arch. PTTD is when there is a change in the posterior tibial tendon, impairing its ability to support the arch of your foot and resulting in a flat foot and discomfort.
PTTD is typically due to overuse but is noted with some traumatic injury (such as stepping off a curb or falling) and is typically associated with activities such as running, walking, hiking or climbing stairs.
Typically symptoms include: pain on the inside of the foot and around your ankle bone, swelling may occur in the same location, flattening of the arch, loss of the ability to resist pushing the foot towards midline, and inward rolling of the ankle. As symptoms persist the arch of your foot starts to flatten and pain starts to crawl up the inside of your leg. As the dysfunctions advances the arch will continue to flatten and pain may be noted on the outside of the ankle as well.
For early stage PTTD physical therapy and exercises can be used to help regain strength and stability of your foot. These exercises include heel raises, resistive ankle strengthening in all planes, intrinsic foot strengthening, lifting your arches and balance activities. Calf stretches and hip strengthening exercises should also be incorporated for increased improvements up the chain.
The author of this article is Alexa Bancel, PT, from Athletico- Gold Coast.