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



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I love Lexington Podiatry! The staff is always so helpful, and attentive. I love Dr. Freels. She is top notch, and is always so happy to see me, and listens to me about what is going on.

Amie Castle


Dr. Carter diagnosed and created a treatment plan in minutes- other podiatrists have treated me incorrectly for years. So pleased to have answers and solutions.

Katy Perkins


My left foot had been hurting for a while. The staff and doctors here are all quite knowledgeable and professional, as well as friendly and personable. My diagnosis was promptly made, x-ray completed right there in the office, and I left with the two braces that I needed. No waiting for the mail, trip to brace shop, nada. Most excellent clinic!

Susan Bell

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.