Dr. thomas mcdonald patient after foot and ankle surgery

How To Treat Posterior Tibial Tendon Dysfunction

Posterior tibial tendon dysfunction (PTTD) is a fairly common issue that develops in the foot and ankle complex. Caught early enough, the condition tends to respond well to conservative care, but more advanced stages may require surgery to provide the best recovery outlook. In today’s blog, we explore why posterior tibial tendon dysfunction develops, and how Dr. McDonald and his team can help you treat the condition.

Causes And Symptoms Of Posterior Tibial Tendon Dysfunction

At its core, posterior tibial tendon dysfunction develops when the posterior tibial tendon becomes damaged, inflamed or otherwise irritated. When this occurs, the tendon may not be able to provide stability to your foot arch, leading to pain and the possibility of fallen arches. There are a number of different ways that this tendon can be injured, but the most common causes are due to acute or chronic stress on the area.

For example, a person who falls off a ladder or who misses a step when going down the stairs may suffer acute trauma to their foot, which can overload and damage the posterior tibial tendon. Chronic stress injuries are even more common, especially among athletes who regularly land with force on their feet when running or jumping. Athletes who play basketball, soccer or tennis are at particular risk for PTTD due to the repetitive forces they put on their tendon and their foot arch while running on particularly hard surfaces. PTTD can be especially troublesome for the athlete because unless it is proactively treated, inflammation and uncomfortable symptoms can linger as they continue to stress the foot and potentially worsen the tendon health.

Symptoms of PTTD include:

  • Pain along the inside of the foot and ankle
  • Swelling along the inside of the ankle
  • Pain that intensifies with activity
  • A visibly fallen foot arch
  • Inhibited gait

If you are dealing with any of these symptoms, or you’re finding that it has become harder to navigate stairs or walk on uneven surfaces, reach out to Dr. McDonald and his team.

Diagnosing And Treating Posterior Tibial Tendon Dysfunction

If you are dealing with any of the above symptoms, your best bet is to connect with a foot and ankle specialist like Dr. McDonald. He’ll review your medical history and take a closer look at your foot during a physical exam. He will be looking for signs of swelling along the arch, and he may ask you to perform a few movement tests to see how your foot and tendon react to different actions. If your specialist wants to get a better understanding of the bone location or tissue health in the area, they may order an X-ray, MRI, CT Scan or ultrasound image.

For the vast majority of patients diagnosed with PTTD, conservative care will be the first form of treatment. Recovery can take weeks or months, but you will likely see enough progress if you stick to your routine such that surgery can be avoided. Oftentimes your specialist will recommend a combination of rest or activity avoidance to protect the tendon from additional stress, ice to help manage localized swelling and promote healing, orthotic inserts to help shape how stress is dispersed on the ankle complex when walking and physical therapy to strengthen the tendon and nearby structures to better support your ankle. When used in combination with one another, these techniques significantly reduce your risk of needing to undergo a corrective procedure for PTTD.

If pain persists after 3-6 months of targeted treatment, or you have a severe case that is really threatening your ankle joint, surgery may be recommended. The specific type of surgery will depend on the location of the tendon problem and the extent of the damage. Your doctor may opt to lengthen the calf muscles to take strain off the posterior tibial tendon, remove the inflamed tendon tissue or transfer healthy tendon tissue from another area to restore function. Your specific procedure will be dictated by your individual needs, but again, most patients do not progress to this stage.

If you’re dealing with lingering ankle pain on the inside of your foot, or walking has simply become more uncomfortable, reach out to Dr. McDonald and his team today to find a solution to your posterior tibial tendon dysfunction. Give his office a call today at (860) 244-8889.

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