Posterior tibial tendon dysfunction (PTTD) is the inflammation or overstretching of the posterior tibial tendon in the foot. The key function of the posterior tibial tendon is to support the arch in the foot. The tendon serves as a major supporting structure to assist the foot function while walking – however, if PTTD is present this function is diminished and the result is oftentimes an “adult-acquired flatfoot.” 

Generally, adult-acquired flat-foot occurs only in one foot, but can be seen in both. This ailment is generally progressive, so if left untreated, the symptoms will continue to get worse. Symptoms generally occur after an activity that requires the use of the tendon such as running, walking, hiking or climbing stairs.

Symptoms of PTTD will change as the condition worsens, but initially include: 


  • Pain
  • Swelling
  • Flattening of the arch
  • An inward roll of the ankle


When PTTD initially develops, it begins with a pain on the inside of the foot and ankle. The area may be red, warm, and swollen, as well. As the arch begins to flatten, there may still be pain on the inside of the foot and ankle, however, the foot and toes begin to turn outward and the ankle rolls inward. As it reaches its advanced stages, the arch continues to flatten and the pain often shifts to the outside of the foot, below the ankle. This indicates that the tendon has deteriorated considerably and arthritis is likely developing in the foot.

Early diagnosis and treatment are key in preventing tendon and joint damage.  Consult your podiatrist today for a complete Biomechanical Exam.  If you suspect PTTD or have additional questions contact us today!

The Aircast AirLift Brace will provide adjustable support and stability.

Excess Flattening of the foot leads to dysfunction and damage of the Tendon!
Improper Lower Extremity Biomechanics is the root Cause.
Without support and proper treatment, Tendon Damage, Dysfunction and Rupture may occur!

Untreated, this condition leads to Arthritic breakdown of the joints in the foot and Ankle!