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Posterior Tibial Tendon

Dysfunction (PTTD)

The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking.

PTTD is often called adult acquired flatfoot because it is the most common type of flatfoot developed during adulthood.

The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in flattening of the foot.

PTTD is often called adult acquired flatfoot because it is the most common type of flatfoot developed during adulthood. Although this condition typically occurs in only one foot, some people may develop it in both feet. PTTD is usually progressive, which means it will keep getting worse, especially if it is not treated early.

Overuse of the posterior tibial tendon is often the cause of PTTD. In fact, the symptoms usually occur after activities that involve the tendon, such as running, walking, hiking or climbing stairs. Patient with flatfeet are the most common individuals that suffer from this condition.

The symptoms of PTTD may include pain, swelling, a flattening of the arch and an inward rolling of the ankle. As the condition progresses, the symptoms will change.

For example, when PTTD initially develops, there is pain on the inside of the foot and ankle (along the course of the tendon). In addition, the area may be red, warm and swollen.

Later, as the arch begins to flatten, there may still be pain on the inside of the foot and ankle. But at this point, the foot and toes begin to turn outward and the ankle rolls inward.

As PTTD becomes more advanced, the arch flattens even more and the pain often shifts to the outside of the foot, below the ankle. The tendon has deteriorated considerably, and arthritis often develops in the foot. In more severe cases, arthritis may also develop in the ankle.

We are able to treat PTTD both surgically and conservatively. Custom orthotics or bracing is helpful to address pain and swelling by placing the foot under the leg. Most OTC braces are not helpful for this condition and only a select few have shown to improve pain. We offer both custom and OTC/ custom bracing in the office without the need of a Rx to a DME supplier.

PTTD as stated is mostly related with genetic or post traumatic collapsing flatfeet and overuse syndrome. Surgery is required to straighten out the foot with either osteotomies or arthrodesis of different bones depending on what joint or bone is the biggest factor. Evans osteotomy, Cotton Osteotomy, Kout ( medial calcaneal osteotomy ) are powerful surgical procedures that can straighten the foot at the same time with repairing the tendon. However, if PTTD is not treated successfully then joint arthritis develops. In these situations joint fusion are needed. Subtalar joints, TN joints, CC joint and or NC joints are requiring to be fused in a straight position.

Recovery from either surgery will require a minimum of 6 weeks without weight on the foot and can take up to 3 months to return to work.

If you are suffering from ankle pain or swelling, prior ankle injury, or weakness of the foot these condition maybe the underlying problem. Let one of our board certified foot and ankle surgeons assess your condition and develop a plan to resolve your pain.

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Comprehensive Care , Advanced Technologies and Minimally Invasive Treatment

Doc Martin’s Foot And Ankle Clincs are well known as one of the most technologically advanced foot and ankle practices in Michigan. Our physicians will carefully craft an individualized treatment plan that embraces your specific injury, anatomy, and even lifestyle (a critically important component when it comes to recovery). We never take a “cookie-cutter approach” to treatment.

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Foot And Ankle Experts In Michigan

For our patient’s convenience, we offer foot and ankle treatments for all kinds of conditions such as Posterior tibial tendon dysfunction in Adrian, MI, Posterior tibial tendon dysfunction in Ann Arbor, MI, and Posterior tibial tendon dysfunction in Jackson, MI. We have our own digital x-ray, MRI, Cat-scan, and ultrasound equipment at many of our podiatry clinics. Our on-site podiatric physical therapy clinics allow for constant communication between the physicians and physical therapists, ensuring the most effective therapy and successful recovery for our patients.

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