Posterior Tibial Tendon Dysfunction

There’s a tendon that runs from the ankle into the foot called the posterior tibial tendon that supports the arch and helps you walk.

Sometimes it stops doing its job, known as posterior tibial tendon dysfunction (PTTD), which over time can lead to a flattening of the arches and adult acquired flat foot.

PTTD Causes

PTTD is often caused by overuse, like excessive running, walking, hiking or long sessions on the Stairmaster. Or it might be a result of direct injury to the tendon, age-related changes, flat feet, over-pronation or obesity.

PTTD Symptoms

The symptoms include pain and swelling, a feeling of warmth or redness along the inside of the foot and ankle, flattening of the arch, and pronation (the rolling inward of the ankle).  

As PTTD progresses, we often see pain in the outside of the foot below the ankle and sometimes arthritis in the foot or ankle.

PTTD Treatment Options

There are a few different treatment options that can stop PTTD from progressing if we catch it in time. Possible treatments might include orthotics to support the feet and ankles, ankle braces and wearing a cast or boot to immobilize the foot and allow healing. These might be accompanied by physical therapy, anti-inflammatory medications and changing the type of shoes you wear. Platelet Rich Plasma Injections (PRP) have also been effective in helping posterior tibial tendon dysfunction.

In very advanced cases when none of these options relieve the pain and progression, surgery might be necessary. But that’s always a last resort.

If you are experiencing foot pain, call our office or make an online appointment


Staff was extremely friendly and professional. They took us back immediately and no waiting for doctor to come in. Dr Settles-Carter was amazing with my little girl. She took her time and explained every detail to my daughter. As we were leaving my little girl said Dr Settles-Carter was the best doctor ever. Coming from a 10yr old.

Bert King

It took some work, and patience, but my feet are much better now. Dr. Freels worked with me to find exercises, and more importantly, the right shoe to wear. So nice not to dread going into work, for the pain of simply walking. Despite what another review here says, they've never tried to sell me any shoes there, have always left the choice up to me.

Robert Griffith

The staff was very courteous. However, the care provided by Dr. Carter and the staff in the back was exceptional! I finally had answers for my health concerns and issues and a course or plan of treatment including the costs of the services they provide. I especially liked the hours of operation...I can see a doctor for the treatment I need without having to use my personal and sick days! Love the flexibility. Lastly, the ambiance esthetics were relaxing and beautiful.

Bonnie Ogle Taylor

The entire staff at Lexington Podiatry was very welcoming and friendly. Jill went out of her way to make sure my daughter was taken care of. We appreciate being seen so quickly (it would have taken weeks to have seen an orthopedist for her foot injury). Now, she is on the road to recovery! Great office, thanks everyone!

Team Wade 24

Had a great experience! Everyone was very nice, it was clean, the doctor took time to listen to me. She showed me my x-rays and explained them to me. I would recommend them to family and friends.

Heather Purvis

Accepted Insurance Providers

There may be providers, plans and coverage not included on this list. We will help you with navigating the options for coverage and costs. We also accept HSA, Flex accounts, Care Credit and prompt pay pricing for treatment at the clinic and surgical procedures. We do not accept Medicaid or CareSource plans at this time. Visit our New Patient page for more details.