Posterior Tibialis Dysfunction (PTTD)

The posterior tibial tendon connects the calf muscle to bones on the inside of your foot, to support the arch on the inside of the foot. When the tendon is injured or breaks down, it may no longer be able to support the arch and painfully affect foot and ankle movements. PTTD is the most common cause of adult- acquired flatfoot.
Graphic displaying where the area of pain is for posterior tibialis dysfunction (PTTD)


Pain and swelling along the ankle or inside of the foot, that increases with activity.
Pain when standing on toes.
Inward roll on the ankle.
Difficulty walking on uneven surfaces or on stairs.
An existing, worsening limp.
Uneven wear on shoes.


A single-limb heel rise test can determine tendon health. With a healthy tendon, patients should be able to complete 8-10 heel raises comfortably. In the early stages of PTTD, it may not be possible to complete one single heel rise.

Suggested Orthotics & Modifications

Device Type: Pathology-Specific Device for Posterior Tibialis Dysfunction.

Device Standard: Minimum cast fill, 22mm Heel Cup, High Medial Flange, 4 Deg. Rear Foot Post, 4mm Medial Skive, 4mm Heel Lift, 1/8 Pull Cover to Toes.

Suggested Modifications: None required for pathology specific devices.


Monday: 8am-4:30pm MST
Tuesday: 8am-4:30pm MST
Wednesday: 8am-4:30pm MST
Thursday: 8am-4:30pm MST
Friday: 8am-4:30pm MST
Saturday: Closed
Sunday: Closed