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Timeline:
0:00 Start
0:35 Anatomy/Function
1:30 What causes this condition?
2:06 Common Presentations
3:17 3 Cardinal Signs
4:13 Calm Things Down
4:47 Rehabilitation Exercises
11:48 Walking/Activity Modifications
12:31 Diagnosis
13:33 Flatfoot Deformity
13:57 Surgical Advice/Options
In this video, we dive into Posterior Tibialis Tendon Dysfunction (PTTD) also known as Posterior Tibialis Tendonitis/Tendinopathy, is a common condition that causes pain and dysfunction in the foot and ankle. The tibialis posterior tendon plays a critical role in supporting the medial arch of the foot and stabilizing movement during walking, running, and standing. When this tendon becomes overstressed, damaged, or inflamed, it can lead to significant pain and potential deformities like flatfoot or collapsed arches.
We’ll begin by explaining the anatomy and function of the tibialis posterior tendon, highlighting its role in foot inversion, plantarflexion, and arch support. You'll learn about the main causes of Posterior Tibialis Tendon Dysfunction, including overuse injuries, trauma, and mechanical overload, where repeated stress on the tendon leads to degenerative changes and inflammation. In many cases, the condition starts with gradual overuse, but it can also present suddenly after an acute injury.
Next, we cover the symptoms of PTTD, which include pain on the inside of the ankle, often under the medial malleolus (the bony bump on the inside of the ankle), swelling, and weakness in the foot. In more severe cases, individuals may experience the collapse of the foot’s arch, leading to flatfoot or the “too many toes” sign, where the toes are visible from behind the foot due to the inward rotation of the ankle. These symptoms are often worsened by weight-bearing activities, such as walking, running, or standing for prolonged periods.
We will walk through the diagnosis of PTTD, including the importance of a clinical exam with palpation, gait analysis, and load testing. We also discuss imaging techniques like X-rays, MRI, and ultrasound, which help assess tendon damage, degeneration, and associated structural changes in the foot.
For treatment, we explore both conservative and surgical options. Conservative treatments focus on reducing inflammation and strengthening the tibialis posterior tendon through rest, physical therapy, orthotics, and taping. We’ll provide detailed examples of rehabilitation exercises, such as banded inversion, calf raises, and short foot exercises, designed to reduce pain and improve tendon strength and capacity.
In more severe cases where conservative measures fail, we’ll discuss surgical options like tendon repair, tendon transfer, and osteotomy to realign bones and restore function.
Whether you’re experiencing inside ankle pain, struggling with flatfoot, or simply want to understand more about tendon dysfunction, this video provides a comprehensive guide to Posterior Tibialis Tendon Dysfunction (PTTD)—from causes to treatments and rehabilitation. Don’t forget to like, comment, and subscribe for more in-depth content on foot and ankle health!
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The information provided in this video is intended as general information and not a substitute for individual medical advice regarding your medical condition. To the extent permitted by law, neither Performance Sport & Spine, nor any of our officers, employees, agents or related bodies corporate will be liable in any way (including for negligence) for any loss, damage, costs or expenses suffered by you or claims made against you through your use of, or in connection with, this video or information supplied or offered to be supplied on this video. Although we use our best efforts to provide accurate information and other materials on this video, the video is provided “as-is”. To the extent permitted by law, all warranties, conditions and representations provided about or by this video are excluded.