Adult Flat Foot | Tibialis Posterior Tendonopathy ( PTTD ) | Wimbledon
PTTD is the most common form of adult acquired flat foot. Flat feet are common and are usually normal, unless patients develop pain or over use injuries such as sports injuries or plantar fasciitis. PTTD is a complex multifactorial pathology of the foot and ankle which has 4 clear clinical stages. The tibialis posterior tendon is a large tendon which arises as a muscle on the inside of the calf and becomes a tendon around the inside of the ankle, which then inserts into the arch. This tendon is responsible for maintaining the arch of your foot and is susceptible to trauma and injury.
Posterior tibial tendon dysfunction ( PTTD ) is an over use of the posterior tibial tendon, where patients develop ankle pain along the inside of the ankle. The posterior tibial tendon can stretch, elongate and microtrauma within the tendon can occur, which damages the tendon’s structure. The arch can collapse and further extensive musculoskeletal disorders can occur if it is left untreated and unmanaged. PTTD is the main cause of “adult acquired flat foot”.
Signs and symptoms of PTTD
- Ankles rolling in
- Pain around the inside of the ankle
- Swelling around the inside of the ankle
- Weakness in the ankle
- Unable to complete a single leg tip toe
- Pain on the outside of the ankle (sinus tarsi)
- Arthritis of the ankle.
During an initial consultation with your podiatrist, they will establish if you have PTTD and discuss the specific treatment programme for your condition. Treatment may consist of: