Posterior Tibial Tendonitis (PTT) is a condition affecting the tendon that supports your foot arch. Left untreated, symptoms and dysfunction can progress, impairing your mobility. However, our Massapequa podiatrists can provide non-invasive relief for this condition by treating posterior tibial tendonitis (also known as posterior tibial tendon dysfunction) with custom orthotics.
What is PTT? ![ankle injury]()
Your posterior tibial tendon runs along the inside of the ankle, ending in your foot and supporting your arch as you walk. Sometimes, it becomes inflamed, leading to tendonitis. Common causes of this inflammation include:
- Overuse
- Unsupportive footwear
- High-impact sports with lots of jumping or quick direction changes
- Weight gain and/or obesity
- Direct injuries to the tendon
- Aging
- Side effects of diabetes or reduced blood flow
Signs and Symptoms
Common PTT symptoms include:
- Pain on the inside of the ankle and foot
- Inner ankle swelling
- Foot flattening due to arch collapse
- Challenges with walking or maintaining balance
When caught early, treating posterior tibial tendonitis with orthotics is extremely effective. However, delaying treatment could lead to increased dysfunction, requiring more advanced interventions.
Treating Posterior Tibial Tendonitis: How Orthotics Can Help
Orthotics can help relieve the pain of PTT while improving function with movement. But how can these custom-made inserts treat this condition? Basically, they support both the foot and the impacted tendon. And, with that stress reduction comes pain relief and better function, as evidenced by this study. Just remember: when PTT progresses, orthotics alone may not provide effective relief. In such cases, more advanced options such as a Ritchie brace or Ankle Foot Orthotic (AFO) may be necessary.
PTT Stages and Treatment Options
When symptoms are limited to mild swelling and pain, orthotics provide highly effective treatment by supporting your arch and reducing inward rolling of the foot (overpronation.) Some people may even find relief with medical grade insoles (MGIs.)
Left untreated, PTT will progress, allowing the beginnings of arch collapse. Pain will increase, and staying active may be difficult and uncomfortable. Now, only custom orthotics will be effective, as they compensate for your exact foot deformity, providing much-needed support and realigning the foot for optimal function. But if treatment is further delayed, you can develop adult-onset flat foot, along with more pain, balance challenges and walking difficulties. For some patients, custom orthotics will still be effective at treating this stage of posterior tibial tendonitis. However, if the deformity is severe, resulting in a rigid flatfoot; tendon rupture; and/or the development of arthritis you may need to progress to the advanced support of an AFO or Ritchie brace. Then, if these fail to provide relief, you may need to pursue other treatment options.
Treating Posterior Tibial Tendonitis on Long Island
At Foot Specialists of Long Island, Dr. Mark Gasparini and Dr. Novneet Chhabra take a multi-pronged approach to treating PTT. This helps us avoid progression and preserve foot function without invasive procedures. While we’ll encourage you to wear your orthotics consistently, we will also suggest resting and icing the affected area, especially at the start of your treatment plan. If pain and swelling are interfering with your daily activities, we may suggest a brief course of over-the-counter, non-steroidal anti-inflammatory medication. Physical therapy may be beneficial to some patients, and, if you’re carrying excess weight, losing a few pounds can help reduce strain on your tendon.
As you heal, we’ll help you safely increase your activity levels, making sure you vary your fitness routine to avoid overuse. We’ll likely also suggest avoiding high-impact sports like tennis or basketball, at least until you’ve fully healed. And, even though you’ll be wearing custom orthotics, we’ll also check out your footwear, making sure that any shoes you select offer adequate cushioning and arch support. For most patients, treating posterior tibial tendonitis this way will result in recovery. However, when non-invasive treatments do not provide adequate relief, surgery may be necessary.
Of course, no one wants to undergo surgery when there are effective, non-invasive treatment alternatives. And that’s why we want you to come see us in the office at the first sign of PTT symptoms. When you seek early intervention, custom orthotics are a highly effective, completely non-invasive treatment option. But if you wait too long, allowing your symptoms to progress and dysfunction to increase, greater interventions may be necessary. So don’t waste time at home, hoping that inner ankle pain will go away on its own. Instead, call us today at 516-804-9038 or follow this link to request an appointment in the office.