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Adult Flat Foot | Tibialis Posterior Tendonopathy ( PTTD ) | Wimbledon

Tibialis Posterior Tendonopathy

Adult Flat Foot | Tibialis Posterior Tendonopathy ( PTTD ) | Wimbledon

The adult flat foot is tone of the more common conditions we see in Podiatry.  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.

Treatment options

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:

  • NSAID’s
  • Heat / ice
  • Biomechanical examination
  • Orthotics.
  • Temporary insoles
  • Strapping
  • Rehabilitation
  • Footwear advice
  • Air cast boot
  • Training modification
  • X-ray, MRI or ultrasound can also be useful.


Specialist Foot & Ankle clinics located in the heart of #Earlsfield, #Wimbledon and #Maidenhead – Schedule online today👇👇👇👇🦶:

South West Podiatry

Clinic locations:

Appointments are available at Earlsfield and Maidenhead clinics.  *On-site diagnostic ultrasound is available at Earlsfield and Maidenhead clinical locations.

How to book:

Click the following link to schedule your consultation online 24/7:  BOOK ONLINE.  Alternatively, speak to our friendly booking team between 9am-5pm Monday-Saturday: 020 7164 6607

Insurance and Fee’s:

We accept most major private medical insurance companies including BUPA, Vitality, WPA, Cigna, AVIVA and Simply Health. A full list of our consultation fee’s including self-pay can be found here:  Insurance and Fee’s. Our Podiatry team are health care professional council registered, meaning they are required to maintain professional standards and continued professional development. As an organisation we have invested in the latest diagnostic technology in order to help our podiatry team, help you. We have onsite diagnostic ultrasound available at Maidenhead and Earlsfield clinics. Infra-red pressure analysis available at Maidenhead and Earlsfield clinics with treadmill examinations.

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