Understanding PTTD

To help you understand the conditon better.

Posterior Tibial Tendon Dysfunction

Posterior Tibial Tendon Dysfunction (PTTD) is a condition that occurs when the posterior tibial tendon, which is responsible for supporting the arch of the foot, becomes inflamed or torn. This can cause a range of symptoms, including pain, swelling, and difficulty walking.

The posterior tibial tendon is a strong band of tissue that runs along the inside of the ankle and foot. It connects the calf muscle to bones in the foot, and helps to support the arch of the foot during movement. When the posterior tibial tendon is damaged or inflamed, it can no longer provide adequate support to the arch, which can lead to a collapse of the arch and a flattening of the foot.

There are a number of factors that can contribute to the development of PTTD, including overuse, trauma, and underlying medical conditions such as obesity or diabetes. Overuse of the posterior tibial tendon, such as with activities like running or jumping, can cause micro-tears in the tendon over time, which can eventually lead to more significant damage.

In some cases, PTTD may also be related to structural abnormalities in the foot, such as flat feet or high arches. These conditions can place additional strain on the posterior tibial tendon, making it more susceptible to damage.

Regardless of the underlying cause, PTTD can be a painful and debilitating condition. Treatment typically involves a combination of non-surgical approaches, such as rest, physical therapy, and orthotics, as well as surgical interventions in more severe cases.

In summary, PTTD is a condition that occurs when the posterior tibial tendon, which supports the arch of the foot, becomes inflamed or torn. This can cause a range of symptoms, including pain and difficulty walking. Treatment typically involves a combination of non-surgical and surgical approaches, and may be tailored to the individual needs of each patient.

Stages of PTTD

Stage 1: Inflammation

In the initial stage of PTTD, the posterior tibial tendon becomes inflamed, but there is no significant damage to the tendon. Patients may experience mild pain and swelling on the inside of the ankle and foot, but may still be able to participate in normal activities. Treatment options for stage 1 PTTD typically include rest, ice, compression, and elevation (RICE therapy), as well as anti-inflammatory medications and physical therapy.

Stage 2: Tendinitis

In stage 2 PTTD, the posterior tibial tendon becomes further inflamed and may begin to degenerate. Patients may experience more significant pain and swelling, as well as a flattening of the arch of the foot. Treatment options for stage 2 PTTD may include immobilization with a cast or walking boot, physical therapy, and the use of orthotics to provide additional support to the foot.

Stage 3: Tendinosis

In stage 3 PTTD, the posterior tibial tendon becomes significantly damaged, and may even begin to tear. Patients may experience severe pain and swelling, and may have difficulty walking. Treatment options for stage 3 PTTD may include surgical intervention, such as tendon repair or reconstruction, as well as non-surgical options such as custom-made orthotics and physical therapy.

Stage 4: Arthritis

In the final stage of PTTD, patients may experience arthritis in the ankle and foot, as well as significant pain and deformity. Treatment options for stage 4 PTTD may include joint fusion or joint replacement surgery, as well as physical therapy and the use of orthotics to manage symptoms.

The stages of PTTD range from mild inflammation to severe damage and deformity. Treatment options vary depending on the stage of the condition, and may include a combination of non-surgical and surgical approaches tailored to the individual needs of each patient. Early diagnosis and treatment can help prevent the progression of PTTD and improve outcomes for patients.

The Role of Orthotics

Working document... To Be Continued in part 2