PTTD stands for Posterior Tibial Tendon Dysfunction, and causes pain and weakness at the arch of the foot. This particular tendon arises from a powerful muscle in the back of the leg which is used to maintain the arch and support the arch when weight-bearing. When this tendon gets stretched or overworked, it can become weakened and progressively lose its ability to function properly. Without the strength of the posterior tibial tendon, the arch can gradually lose height, leading to flatfoot.
Signs and Symptoms of PTTD:
- Pain and swelling on inside of ankle or arch
- Loss of arch height or development of flatfoot
- Weakness and inability to perform “heel raise test” (or standing on tippy toes)
- Tenderness over mid-foot or gradual pain on outside of ankle or foot
Certain risk factors are associated with PTTD, and it is found most often in female patients over 50 years of age who are overweight. Posterior Tibial Tendon Dysfunction is also more common in those with diabetes, hypertension, previous foot/ankle surgery or trauma, and certain inflammatory disease such as Rheumatoid Arthritis, Spondylosing Arthropathy and Psoriatic Arthritis. Athletes like runners or those involved in jumping sports such as basketball and soccer are also predisposed to developing injuries to the posterior tibial tendon. Once the tendon is injured, it is important to rehabilitate the tendon properly so it does not continue to weaken and place stress on other important structures of the foot and ankle.
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