Definition: The Posterior Tibialis Tendon is an important structure that works to hold up the arch of the foot. It runs behind the ankle bone on the inside of your ankle (medial malleolus), across the instep and attaches to the inside of the midfoot Sometimes this tendon can become overstretched or inflammed. This can lead to an aquired flat foot. There are several names for this type of condition such as, tibialis posterior tendon dysfunction, adult acquired flatfoot deformity and tibialis posterior insufficiency.

Function: Posterior Tibial Tendon Dysfunction (PTTD) can be caused by a dysfunction or partial/complete tear of the posterior tibialis muscle/tendon.

• Pain along the inside of the ankle into the long arch.
• The pain becomes worse with activities or longer periods of standing.
• An insufficient ability to push off your toes when running.
• Unsteady feeling when walking.
• New pain develops around outside ankle bone.
• Change in footshape (loss of arch) in the later stages.

• Pain along the inside of the ankle into the long arch.
• The pain becomes worse with activities or longer periods of standing.
• An insufficient ability to push off your toes when running.
• Unsteady feeling when walking.
• New pain develops around outside ankle bone.
• Change in footshape (loss of arch) in the later stages.

• An acute injury, such as a fall.
• Overuse by people who do high impact sports.
• Flat feet or feet that overpronate (when the inside ankle and arch roll towards the ground).
• Poor blood supply.
• Most common in women over 40 years old.
• Additional risk factors are obesity, diabetes and high blood pressure.

• Rest
• Ice 15 minutes several times a day
• Physiotherapy and bracing
• Taping
• In extreme cases, surgery