PTTD is the most common cause of flat feet in adults. It typically presents in only one foot but occasionally it can be in both feet.
The posterior tibial tendon (PTT) plays a critical role in supporting the arch of the foot. Maintaining good arches in the foot is really important as the arches help distribute the weight and acts as a spring/dampener to reduce the impact of stepping. Without good arch support we can get injuries not only to the foot but to the knees, hips and spine.
The PTT begins as a muscle deep in the calf and runs under the big bone on the inside of your ankle and into the foot. PTTD is a condition in which changes to this tendon impair its ability to support the arch.
PTTD is caused by overuse of this tendon from activities such as running, walking, hiking or climbing stairs. As well as the appearance of a flat foot other symptoms can include pain and swelling on the inside of the ankle, later the ankle may start to roll inwards and the toes begin to turn outwards.
A simple test to determine whether you have this condition is a single calf raise so take the normal foot off the ground then try and raise up onto tiptoes on the other foot. If this action causes pain along the inside of the ankle it is very likely you have PTTD.
Early diagnosis* and treatment is crucial in managing this condition to avoid chronic pain and in severe cases further development of flat foot and arthritis in the foot and ankle. Initially it is very important to rest from high impact exercise, in severe cases complete rest may be necessary.
The next step is to get advice on orthotics to support the arch and take the pressure off the tendon. Anti inflammatory medications will reduce inflammation along with ultrasound. Once the inflammation has settled physical therapy and exercise can return the tendon to normal function.
*Please consult your GP as a first point of call if you are suffering pain
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