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What is PTTD?

PTTD, colloquially known as fallen arches or flat feet, occurs when the posterior tibial tendon, a key player in supporting the arch and maintaining the foot’s structure, becomes inflamed or torn. This can cause the arch of the foot to collapse, leading to an array of complications and discomforts.

There are two types of flat feet. First, there’s flexible flat feet, which is the most common. With this, you can see the arches in the feet when the individual isn’t standing, but they disappear when the individual puts weight on the foot. The other type is rigid flat feet, and with this variety of flat feet, the arch is not visible no matter what position the individual is in.

PTTD is also known as adult acquired flatfoot, because it is the type of flat foot most often seen in middle aged patients. With PTTD, both flexible and rigid flat feet are possible, depending on the progression of the condition. As PTTD progresses, there will be more damage to the foot and ankle joint, and could result in an acquired flatfoot deformity.

What can cause PTTD?

The causes of PTTD are often multifactorial, including a combination of any of the following :

  • Overuse and Injury:PTTD is commonly seen in people who put high stress on their feet, such as athletes (particularly runners) or individuals with jobs that involve a lot of standing or walking. The constant strain can lead to inflammation and eventual tearing of the posterior tibial tendon.
  • Obesity:Higher body weight puts extra stress on tendons in the body. This increased stress can lead to wear and tear over time, causing the tendon to weaken and eventually fail.
  • Hypertension and Diabetes:These conditions, especially when uncontrolled, can affect the body’s circulation and the health of tendons and soft tissues.
  • Flatfoot from birth or childhood (Pes Planus):People who’ve had flat feet since birth or childhood are more likely to develop PTTD, as the tendon may have been overcompensating for the lack of arch structure and eventually wears down.
  • Improper footwear:Shoes that do not provide proper support can contribute to the development of PTTD.

What are the symptoms of PTTD, and how is it diagnosed?

PTTD can present with a variety of symptoms that typically develop gradually and worsen over time. Some of the most common symptoms include:

  • Pain:This is often the first symptom of PTTD. Pain is typically felt on the inside of the foot and ankle, along the course of the tendon. In some cases, pain may also be felt at the outside of the ankle due to the foot turning outward.
  • Swelling:Swelling may occur along the ankle’s inside, reflecting the tendon’s inflammation.
  • Difficulty walking or standing:Standing or walking for long periods of time may become challenging, especially on uneven terrain or when carrying large goods.
  • Change in foot shape:As the illness worsens, the arch of the foot may eventually flatten, the heel may begin to turn outward, and the forefoot inward.

It’s crucial to see a healthcare professional for a diagnosis if you are exhibiting any of these signs. In addition to medical history-taking, you may be asked to stand on your toes as part of a physical test, as people with PTTD frequently struggle to complete this task. Imaging studies may also be required.

What are the treatment and aftercare options for PTTD?

Treatment for PTTD largely depends on the severity of the condition and is typically progressive, starting with less invasive methods and moving towards more involved treatments if the condition doesn’t improve. Conservative treatments include rest and ice, physical therapy, orthotics and bracing, oral medications, or steroid injections. If these fail to relieve symptoms or if the condition is severe, surgery might be recommended.

Your best foot forward

When it comes to foot health, timely action is key. Don’t let the discomfort of flat feet keep you from enjoying life to the fullest. At Texas Orthopaedic Associates, we believe in stepping forward together toward a future where pain doesn’t hold you back. Get in touch with us today, and let’s begin your journey to better foot health together.