Posterior Tibial Tendon Dysfunction

Posterior Tibial Tendon Dysfunction Acquired Adult Flat Foot Treatment

Posterior Tibial Tendon Dysfunction Treatment

Pain along the inside of your ankle or a collapsing arch?

Pain on the inside of your ankle, a flattening arch or adult-acquired flat foot may be signs of Posterior Tibial Tendon Dysfunction (PTTD).

Early diagnosis is important, as the condition can gradually progress if left untreated. Our experienced podiatrists provide expert assessment and personalised treatment to reduce pain, support your arch and help you stay active.

Book your Biomechanical Assessment today.

How do I know if I have Posterior Tibial Tendon Dysfunction?

PTTD often develops gradually rather than after one specific injury.

Common symptoms include:

  • Pain along the inside of the ankle

  • Pain or aching in the arch of the foot

  • Swelling around the tendon

  • A flattening or collapsing arch

  • Foot fatigue

  • Difficulty walking longer distances

  • Pain during standing or walking

  • Difficulty standing on tiptoe

  • Reduced balance or stability

  • Changes in the shape of your foot

Many people notice symptoms becoming progressively worse over months or years.

What is Posterior Tibial Tendon Dysfunction?

The posterior tibial tendon runs along the inside of your ankle and helps support the arch of your foot.

It plays an important role in:

  • Supporting the arch

  • Controlling foot movement

  • Stabilising the foot during walking

  • Helping propel the body forwards

When the tendon becomes weakened or overloaded, it can no longer support the foot effectively.

Over time this may lead to:

  • Adult-acquired flat feet

  • Progressive arch collapse

  • Pain

  • Changes in walking mechanics

What causes Posterior Tibial Tendon Dysfunction?

There is rarely one single cause.

Several factors may contribute, including:

  • Age-related tendon changes

  • Foot biomechanics

  • Flat feet

  • Previous injuries

  • Prolonged standing or walking

  • Certain medical conditions affecting tendon health

PTTD is one of the most common causes of adult-acquired flat feet.

How we treat Posterior Tibial Tendon Dysfunction

Treatment depends on the stage of the condition, your symptoms and your lifestyle.

Following a comprehensive assessment, we'll consider:

  • Your symptoms

  • Foot posture

  • Tendon function

  • Walking pattern

  • Activity levels

  • Footwear

  • Your goals

Your personalised treatment plan may include:

  • Footwear advice

  • Rehabilitation exercises

  • Custom Foot Orthotics

  • Activity modification

  • Bracing where appropriate

  • Referral for specialist opinion if required

Biomechanical Assessment

Understanding why the tendon has become overloaded is one of the most important parts of treatment.

Your assessment may include:

  • Clinical examination

  • Tendon assessment

  • Foot posture assessment

  • Biomechanical assessment

  • OptoGait gait analysis

  • Functional testing

  • Footwear review

Where appropriate, diagnostic imaging may also be recommended.

Rehabilitation

Targeted rehabilitation may help improve:

  • Tendon strength

  • Lower limb strength

  • Foot stability

  • Walking efficiency

  • Confidence during activity

Custom Foot Orthotics

Custom Foot Orthotics are often one of the most effective treatments for PTTD.

They may help:

  • Support the arch

  • Reduce strain on the tendon

  • Improve foot function

  • Slow progression of the condition

  • Improve comfort during walking

Activity modification

Remaining active is important, although temporary adjustments to walking, exercise or standing may sometimes be recommended while the tendon settles.

Pricing

Every treatment begins with a comprehensive assessment so we can understand why your symptoms have developed and recommend the most appropriate treatment.

Treatment Price
New Patient Biomechanical Assessment £180
Principal Podiatrist Biomechanical Assessment £225

If you're unsure which appointment is most suitable, our Patient Care Team will be happy to help.

Book your appointment

Pain along the inside of your ankle or a flattening arch shouldn't be ignored.

Whether your symptoms have recently started or have been progressing for some time, we're here to help.

Book your Biomechanical Assessment today and take the first step towards moving with comfort, confidence and ease.

Why Patients Choose Callen Olive

Your feet deserve more than treatment.

At Callen Olive, we believe exceptional podiatry is about far more than relieving pain.

It's about understanding how your feet affect your comfort, confidence and the way you move through life.

Every person who walks through our doors has different goals, which is why every treatment plan is tailored to your individual needs, lifestyle and ambitions.

Because no two people — or feet — are the same.

Expert Care. Personally Delivered.

We combine specialist clinical expertise, advanced technology and genuinely personalised care to help you achieve the best possible outcome.

From your first appointment, you'll understand what's causing your symptoms, the treatment options available and how we'll support you every step of the way.

Why Patients Choose Callen Olive

  • Specialist podiatry team
  • Personalised treatment plans
  • Advanced technology
  • Evidence-based care
  • Award-winning patient experience
  • Trusted by thousands of patients every year

More Than A Podiatry Appointment

Exceptional care isn't just about clinical expertise.

It's about feeling listened to, understood and supported from the moment you arrive until long after your treatment has finished.

Because that's what great care should feel like.

We Care.

It's more than our promise.

It's how we listen, how we explain, how we treat and how we support every patient who places their trust in us.

Because helping you move with comfort, confidence and ease is why Callen Olive exists.

Healthy Feet. Healthy Body. Healthy Mind.

 

Frequently Asked Questions

Can flat feet develop in adulthood?

Yes. Posterior Tibial Tendon Dysfunction is one of the most common causes of adult-acquired flat feet.

Will my arch continue to collapse?

Not necessarily. Early assessment and appropriate treatment may help support the tendon and slow progression of the condition.

Can orthotics help PTTD?

Yes. For many people, custom orthotics help support the arch, improve foot function and reduce strain on the tendon.

Will I need surgery?

Most people do not require surgery and respond well to conservative treatment. Surgery is usually considered only if symptoms continue to progress despite appropriate management.

Can I continue walking?

In many cases, yes. Your clinician will advise how much activity is appropriate while your tendon recovers.

Is PTTD the same as having flat feet?

No. PTTD is a tendon condition that can lead to adult-acquired flat feet as the tendon becomes less able to support the arch.

Further information

Why early assessment matters

Posterior Tibial Tendon Dysfunction is often a progressive condition.

Many people initially assume they have a minor strain or that their arch is simply changing with age.

Without appropriate treatment, symptoms may gradually progress and contribute to:

  • Permanent flattening of the foot

  • Arthritis

  • Reduced mobility

  • Reduced walking tolerance

  • Loss of confidence

  • Increased likelihood of surgical intervention

Early diagnosis provides the best opportunity to maintain foot function and long-term mobility.

Why doesn't rest always work?

Whilst reducing aggravating activities may help temporarily, rest alone rarely addresses the underlying problem.

Successful treatment often involves improving:

  • Foot biomechanics

  • Tendon strength

  • Footwear

  • Lower limb function

  • Activity management

The goal is not simply to reduce pain today but to slow progression and improve long-term function.

Understanding the stages of PTTD

Posterior Tibial Tendon Dysfunction progresses over time if left unmanaged.

Stage One

  • Pain and swelling

  • Tendon irritation

  • Arch remains normal

Stage Two

  • Tendon weakness

  • Flexible flat foot

  • Progressive arch collapse

  • Difficulty performing a single-leg heel raise

Stage Three

  • Rigid flat foot

  • Arthritis developing within the foot

  • Reduced mobility

Stage Four

  • Advanced deformity

  • Ankle arthritis

  • Significant functional limitations

Understanding the stage of your condition helps guide the most appropriate treatment.

Can I continue walking?

For many people the answer is yes.

Remaining active is important for both physical and mental wellbeing.

Simple changes to footwear, activity levels and support often allow people to remain active whilst protecting the tendon during recovery.

Related conditions

  • Adult Flat Feet

  • Plantar Fasciitis

  • Achilles Tendinopathy

  • Foot & Ankle Arthritis

  • Hallux Rigidus

Related treatments

  • Biomechanical Assessment

  • OptoGait Gait Analysis

  • Custom Foot Orthotics

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