Posterior Tibial Tendon Dysfunction

Posterior Tibial Tendon Dysfunction Treatment in St. Louis, MO

If you’re experiencing pain or weakness in your foot or ankle, it could be a sign of posterior tibial tendon dysfunction. This condition affects the tendon that supports the arch of your foot and can lead to further complications if left untreated. It can also negatively impact daily activities, such as walking, running, and standing for extended periods.

Seeking prompt evaluation and treatment is essential to managing symptoms and restoring function effectively. At Missouri Foot & Ankle, we are committed to helping you regain your strength and mobility. Our podiatrists specialize in posterior tibial tendon dysfunction treatment in St. Louis, MO—request your appointment today!

What Is Posterior Tibial Tendon Dysfunction?

Posterior tibial tendon dysfunction (PTTD), also known as posterior tibial tendon insufficiency or adult-acquired flatfoot, describes a painful, progressive flatfoot deformity in adults. Adult-acquired flatfoot is characterized by the gradual stretching of the tibialis posterior tendon and ligaments that support the foot’s arch. Unlike most flat feet seen in children, this condition leads to pain due to tears in the soft tissues (tendons and ligaments).

Common symptoms include pain along the inner ankle, swelling, and difficulty walking or standing for long periods. The deformity worsens as vital ligaments and the posterior tibial tendon deteriorate, leaving no support for the arch. Without treatment, PTTD can severely impact daily activities, limiting mobility and quality of life.

Demographics and Risk Factors

This condition affects women four times more frequently than men, typically occurring in individuals aged 60 and older. Most people who develop the condition already have flat feet. Risk factors for developing PTTD include obesity, diabetes, and advancing age.

Stages of Adult Acquired Flatfoot

Understanding the stages of adult-acquired flatfoot is essential for effective diagnosis and treatment.

Stage I: Inflammation and swelling of the posterior tibial tendon around the inside of the ankle.
Stage II: Visible deformity comparing one foot to the other, as the symptomatic foot becomes flatter and more deformed. The deformity is movable and correctable in this stage.
Stage III: The foot progresses to a rigid, painful, flat foot deformity primarily found on the outside of the ankle.

Treatment of Posterior Tibial Tendon Dysfunction

Early intervention is crucial for effectively treating posterior tibial tendon dysfunction. Addressing the condition in its initial stages can help prevent further complications and improve overall outcomes. When caught early, treatment options are generally more successful and can significantly alleviate foot pain while promoting healing.

Stage I Treatment

During Stage I, rest, protected ambulation in a cast, and anti-inflammatory therapy effectively reduce inflammation and tendon injury. After initial symptoms have subsided, custom-molded foot orthoses and athletic or orthopedic footwear maintain foot and ankle stability.

Stage II and Beyond

As the tendon stretches, the affected foot may visibly roll into a pronated position. Non-surgical treatments are less likely to succeed at this stage. Total immobilization in a cast or Camwalker may alleviate symptoms and slow deformity progression for some patients. However, long-term use of an ankle-foot orthosis (AFO) is often necessary to prevent further deformity without surgery.

The Richie Brace is a newer AFO that has shown significant success in treating Stage II posterior tibial dysfunction. This sport-style brace, paired with a custom foot orthotic, fits comfortably into most lace-up footwear. Other options include the Arizona, California, or gauntlet brace, with the choice depending on the patient’s needs.

Surgical Options

If non-surgical interventions like casting, orthoses, and shoe therapy fail, surgery may be the next option. Common surgical procedures include tendon debridement, tendon transfers, osteotomies (cutting and repositioning of bone), and joint fusions. Patients should thoroughly discuss the benefits and risks of all surgical options, as most procedures require significant recovery time.

Get Expert Care for Posterior Tibial Tendon Dysfunction

If you’re experiencing symptoms of posterior tibial tendon dysfunction, it is essential to seek help as soon as possible. Missouri Foot & Ankle’s podiatrists utilize advanced treatment options to alleviate pain and improve your mobility.

Contact Missouri Foot & Ankle for treatment of posterior tibial tendon dysfunction in St. Louis!