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A Slow Collapse: Posterior Tibial Tendon Dysfunction

Tension bridges work because heavy cables help support and distribute the weight of the structure. Without those cables, the bridge cannot support all areas. Your body has its own “cables” that support the pressure and weight of certain structures. This is definitely the case for your arches: your posterior tibial tendons help stabilize your midfoot much like a bridge cable. That’s why posterior tibial tendon dysfunction (PTTD) can lead to problems like progressive flatfoot and arch pain.

How a Tendon in Your Calf Holds Up Your Arch

Support for Your ArchYour posterior tibial tendon starts in your calf. It runs down your leg and behind the bump on the inside of your ankle. From there it actually tucks under your arch and attaches to a bone on the underside of your midfoot. The tendon acts kind of like a sling, helping hold and stabilize your arch. Holding up the midfoot and controlling your arch when you walk is this tendon’s main purpose.

Naturally, this means if the tendon is damaged in some way, it isn’t able to hold up your arch effectively. Your arch is instead able to roll inwards further than normal and collapse downward. Eventually this can result in progressive flatfoot. You feel pain along the damaged tendon, but also may struggle with swelling and soreness when you’re active. You might develop weakness that makes it difficult to rise up on your toes as well.

Problems That Weaken Your Posterior Tibial Tendon

Posterior tibial tendon dysfunction (PTTD) is any issue that weakens this tendon so it becomes less effective at supporting your arch. This can range from overuse injuries like tendonitis and tendonosis to actual tears in the tissue. It’s most common in people whose arches are under a lot of stress, overworking the connector and causing inflammation and weakness. For example, struggling with obesity is a major source of tendon dysfunction. Certain preexisting conditions like diabetes and hypertension, as well as inflammatory diseases like rheumatoid arthritis, psoriasis, and Reiter’s syndrome, can all contribute to deterioration in the tendon. Previous trauma to the inside of your ankle can weaken the connector and make it prone to allowing the arch to collapse as well.

Supporting and Stabilizing Your Midfoot

Unless you actively treat the problem, your posterior tibial tendon will not heal on its own. Instead, your PTTD will increase and worsen, allowing your arch to become flatter and flatter. Eventually your flatfoot can become rigid and increase your risk for arthritis. You might develop pain on the outside of your ankle from bones shifting oddly. You might even have trouble walking and wearing some shoes. Fortunately, PTTD is treatable. Our team at Absolute Foot Care Specialists will examine your lower limbs to diagnose the exact problem and what may have contributed to it. Then we can discuss your treatment options.

Normally, conditions like this can be treated conservatively. Resting the foot and minimizing inflammation are important for helping the tendon heal. You may need to use special orthotics in your shoes to support your midfoot, so it handles stress and pressure better. For more advanced cases of PTTD, you might need to wear a special foot brace to stabilize your arch as you recover. Physical therapy can help you rebuild tendon strength in the limb to fight weakness issues. In rare cases when noninvasive methods are not enough, surgery may be needed to repair the damage.

Your arches are important structures for your lower limbs, so keeping their supporting “cables” healthy and pain-free is important, too. Don’t wait until your feet have gone flat to get help with issues like PTTD. Instead, let experts like us at Absolute Foot Care Specialists in Las Vegas take care of your midfoot and tendons. Contact us today if you’re experiencing any kind of arch pain. You can reach us by calling (702) 839-2010 or by using the online forms.