What Is PTTD?
Posterior Tibial Tendon Dysfunction (PTTD), often called adult-acquired flatfoot, occurs when the posterior tibial tendon—which supports your foot's arch—becomes inflamed, stretched, or torn. As the tendon weakens, the arch gradually collapses, leading to a flat foot, inward ankle rolling, and chronic inner ankle pain.
Common Symptoms
Pain and swelling along the inner side of the ankle and foot arch · Progressive flattening of the foot arch over time · Inward rolling of the ankle (pronation) causing shoes to wear unevenly on the inner edge · Pain on the outer ankle as the collapsed heel bone shifts out of alignment · Inability to perform a single-leg heel raise
Our Treatment Approach
Diagnostic ultrasound / MRI tendon evaluation & staging → rigid custom orthotics or custom AFO braces to support the collapsing arch → physical therapy for calf stretching and tendon strengthening → surgical reconstruction or tendon repair for advanced flexible or rigid deformities.
