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Tibialis Posterior Syndrome (PTTD)
Posterior Tibial Syndrome is also known as Posterior Tibial Tendon Dysfunction or PTTD. It is a dysfunction of the muscle, resulting in a fallen arch, or flat feet. It is often confused with Tibialis Posterior Tendinopathy.
Symptoms of Posterior Tibial Tendon Dysfunction
Symptoms include a fallen arch of the foot. There may be a history of injury to the tibialis posterior muscle. There may be pain present, although this is usually associated with a secondary condition, such as a tendinopathy or a tear.
What is Posterior Tibial Tendon Dysfunction?
There is much confusion over the name of this condition with it being referred to as any of the following:
- Posterior Tibial Tendon Dysfunction (PTTD)
- Posterior Tibial Tendon Syndrome
- Tibialis Posterior Syndrome
- Posterior Tibial Insufficiency
- Adult Acquired Flatfoot
All of these conditions are the same and so we will interchange them in this article.
The tibialis posterior muscle comes from behind the shin bone (tibia) and runs into a tendon that passes behind the bony bit on the inside of the ankle (medial malleolus). The function of Tibialis Posterior is to plantar flex the ankle - point the foot down and also to invert the foot - turn the sole of the foot inwards.
There is some confusion between this condition and that of Tibialis Posterior Tendinopathy and the terms are often used interchangeably. The true meanings of these conditions are slightly different. Tibialis posterior tendinopathy is just that - a degenerative, painful injury to the tendon of the Tibialis Posterior. Posterior Tibial Syndrome is slightly different. It is a dysfunction of the muscle, resulting in a fallen arch, or flat feet.
Because the Tibialis Posterior muscle is responsible for inverting the foot, if it is not working correctly, then this causes the arch of the foot to flatten when we stand, walk or run. This can cause further injury problems such as plantar fasciitis.
Treatment of PTTD
What can the athlete do?
- Treatment of any associated conditions such as Tibialis Posterior Tendinopathy.
- Strengthening of the Tibialis Posterior muscle - this can be achieved using rehab band to resist plantarflexion and inversion
- Try arch support insoles to support the arch of the foot.
What can a sports injury specialist or doctor do?
- Treat the associated injury through sports massage, electrotherapy and exercise rehabilitation.
- Prescribe custom made insoles to help support the arch of the foot.
