If you've been diagnosed with posterior tibial tendon dysfunction (PTTD), you're likely trying to decide how to go about treating it, and wondering whether specialized shoes will provide the relief you need. The choices can feel overwhelming but also urgent when you're dealing with the daily discomfort and mobility challenges that come with PTTD.
What you may not know is that you have more options than simply buying specific shoes to help you feel better not only in the coming days, but for years to come.
What is PTTD?
Posterior tibial tendon dysfunction occurs when the tendon that connects your calf muscle to the bones on the inside of your foot becomes inflamed or torn. This tendon plays a crucial role in supporting your arch and helping you walk properly. When it's not functioning correctly, you may experience pain along the inside of your foot and ankle, swelling, and a gradual flattening of your arch.
While PTTD doesn't always result in debilitating pain, it often reduces mobility with increasing discomfort over time. Many people notice their symptoms worsen with activity and improve with rest. Without proper treatment, the condition can progress, leading to more severe complications and potentially requiring surgery to correct.
Treating Posterior Tibial Tendon Dysfunction
The good news is that posterior tibial tendon dysfunction can often be managed effectively when identified and treated early. The two generally recommended forms of treatment are physical therapy and custom orthotics, with many healthcare providers recommending both approaches for optimal results.
Early intervention is key to preventing the progression of PTTD. When caught in its initial stages, simple treatments can reduce pain, improve function, and help you return to your normal activities. The goal is to find treatments that reduce inflammation, support the arch of the affected foot, and strengthen the surrounding muscles to compensate for the weakened tendon.
Physical therapy
The biomechanics of the foot are complicated but not set in stone. A skilled physical therapist can help address the underlying issues contributing to your posterior tibial tendon dysfunction through targeted exercises and manual techniques.
Physical therapy for PTTD may be different for everyone, but typically includes several key components:
- Strengthening exercises focus on the muscles that support your arch and help stabilize your foot during movement. These exercises target the posterior tibial muscle, as well as surrounding muscles in your foot, ankle, and lower leg.
- Stretching techniques address tightness in your calf muscles and Achilles tendon, which can contribute to increased stress on the posterior tibial tendon. Improved flexibility can reduce tension and allow for better foot mechanics.
- Manual therapy involves hands-on techniques to improve joint mobility and reduce muscle tension. Your physical therapist may use soft tissue mobilization, joint mobilization, or other manual techniques to address restrictions in your foot and ankle.
- Balance and proprioception training helps retrain your body's awareness of foot position and improves stability. This type of training can be particularly beneficial for preventing future injuries and improving overall function.
- Gait analysis and correction identifies abnormal movement patterns that may be contributing to your condition. Your therapist can provide guidance on proper walking mechanics and suggest modifications to reduce stress on the affected tendon.
Prescription orthotics
Custom orthotics are an everyday benefit to people with fallen arches and flat feet, including those with a PTTD diagnosis. Evidence points to orthotics being effective at reducing pain and helping people move around easier while they wear them.
Unlike over-the-counter arch supports, prescription orthotics are custom-made based on a detailed evaluation of your feet and specific condition. They're designed to address your unique biomechanical needs and provide targeted support where you need it most.
Everyone’s feet are unique, and so are custom orthotics. In general, orthotics for posterior tibial tendon dysfunction typically feature several important characteristics:
- Medial arch support helps reduce stress on the posterior tibial tendon by supporting the arch and preventing excessive flattening of the foot during weight-bearing activities.
- Motion control features limit excessive pronation (inward rolling) of the foot. Excessive pronation can place additional strain on the already compromised tendon.
- Heel stability provides a stable foundation for the foot and helps maintain proper alignment during walking and other activities.
- Customized fit ensures that the orthotic works with your specific foot shape and addresses your individual biomechanical issues.
The beauty of custom orthotics lies in their versatility. Once you have a pair that works well for you, they can be transferred between different shoes, allowing you to maintain consistent support throughout your day.
Why PTTD shoes may not be the best solution
Buying the best shoes for posterior tibial tendon dysfunction might seem like a logical first step to reducing your pain, but this approach has a few limitations that could make it less effective than other treatment options.
The main challenge is that many people only find the shoe that's right for them through trial and error. Maybe you'll get lucky and find relief with the first pair you try, but you may not. This process can become expensive, or at least a logistical hassle to constantly order and return shoes that don’t work.
Manufacturing inconsistency presents another problem. Shoes that provide excellent support and pain relief initially may not be manufactured the same way the next time you need to buy them. Even minor changes in materials, construction methods, or factory processes can alter how the shoe fits and functions, potentially leaving you back at square one in a year or two.
The lifestyle limitation factor is also worth considering. If you do find one shoe that works exceptionally well, would you be comfortable wearing only that style for all your activities? Most people want variety in their footwear for different occasions, weather conditions, and activities. Relying solely on one specific shoe can be restrictive and impractical for many lifestyles.
Orthotics for posterior tibial tendon dysfunction
Managing posterior tibial tendon dysfunction requires a comprehensive approach that addresses both the symptoms and underlying causes of your condition. While specialized shoes may provide some relief, custom orthotics offer a more targeted, flexible, and cost-effective long-term solution.
If you're ready to explore how custom orthotics can help manage your posterior tibial tendon dysfunction, the next step is to call or request an appointment with our team. Whether you live in West Michigan and can come in for an appointment, or need to take advantage of our virtual care option, we’ll be able to get the information we need to help you stand, walk, and live your life with less pain.
