If you've been experiencing pain in your feet and have noticed that your arches are falling, you may be suffering from posterior tibial tendon dysfunction (PTTD). Your posterior tibial tendon connects the bottom of your foot to a muscle in your calf, and it provides support for the arch of your foot. When it's damaged and becomes lax, the arch of your foot will begin to fall. Fallen arches can make walking difficult and painful. To learn more about the causes of PTTD and how you can treat it, read on.
What Causes PTTD?
PTTD is most often an overuse injury. Placing repeated stress on the posterior tibial tendon causes it to become inflamed. Eventually, the tissue in the tendon will begin to break down and lead to PTTD symptoms. It's most commonly experienced by people who stand on their tiptoes frequently, such as basketball players, tennis players, and ballet dancers, since this places strain on the posterior tibial tendon. However, PTTD can also occur in non-athletes as well.
PTTD can also be caused by direct injury to the posterior tibial tendon. If you fall down, you may tear the tendon and immediately begin to suffer severe PTTD symptoms.
What Are Signs That You May Have PTTD?
If you have PTTD, you'll most likely have pain and swelling around the tendon itself. The pain will usually worsen while walking or after standing up for a long period of time. As PTTD progresses, the arch of your foot will begin to fall, and you'll begin to have symptoms associated with flat feet.
The arch of your foot allows your weight to be distributed evenly across your entire foot. When your arch falls, the uneven weight distribution tends to cause severe pain on the outside of your foot after walking or standing for a long period of time.
Additionally, people who have PTTD are often unable to stand on their tiptoes without experiencing pain. Standing on your tiptoes places a significant amount of tension on the posterior tibial tendon, which will result in pain when it's torn and inflamed.
How Can You Treat PTTD?
Foot surgery is often required to treat PTTD. Before considering surgery, however, your doctor will likely recommend that you start with non-invasive treatments. You'll need to give your posterior tibial tendon a chance to heal on its own. Taking a break from physical activity, wearing shoe orthotics that relieve stress on the tendon, and performing physical therapy exercises will all help your tendon heal. The posterior tibial tendon heals very slowly, however, so it's not unusual to continue experiencing symptoms for months after starting treatment.
When non-invasive treatment options don't work, then your doctor will likely recommend foot surgery. This is also the preferable option when your PTTD symptoms are so severe that you have difficulty walking or standing at all. Several surgical techniques are available to treat PTTD, such as replacing the posterior tibial tendon with another tendon in your foot, removing damaged tissue from the tendon, or removing bone from the bottom of your foot in order to shape it into a normal arch. In most cases, a combination of these surgical techniques is used to alleviate PTTD symptoms.
If you think that you're suffering from PTTD due to fallen arches and persistent foot pain after standing or walking, schedule an appointment with a foot and ankle specialist in your area. PTTD can be diagnosed by taking an X-ray or MRI of your foot in order to check the shape of your arch and the health of your posterior tibial tendon. It's important to diagnose and treat this condition as soon as possible since it tends to worsen over time — walking with fallen arches can cause damage to the rest of your foot, making your issues worse.