Posterior Tibial Tendon Dysfunction (PTTD). The best self help treatments.

[@VisyVisyTV]

One of the best PTTD videos I've watched so far. Thank you.

[@PhysioMSK]

Thanks 😊

[@Joy_LaFaye]

Yees! I was thinking the same thing!

[@terrisidell7041]

I have been to 3 podiatrists and had no real help. I was beginning to feel like you said rest was better until felt better. I have worn custom insoles since grade school and always wore tie shoes, but the last 6 years have been the worst for my ankle. My ankle swelled like a balloon in Oct. It is still swollen now 10 months later. The swelling may also be due to arthritis as you mentioned and I hoped it isn't going to become like my forefingers that won't bend and are bent. Thank you for the listing of arch supports, and exercises to help. I went for Physical Therapy for 6 weeks four months ago and the only thing that made the ankle feel better was the ultrasound therapy. I am looking forward to viewing your other videos, since this one has been so helpful.

[@nicolemartin.NH-FL]

This just started for me 5 days ago, one of the most helpful videos I have watched. Thank you.

[@theaviatroy]

Hello how are your tendons so far after 2 weeks?

[@nicolemartin.NH-FL]

@@theaviatroy I had a setback from walking my puppy and had to rest more, but the swelling is finally down; still aches. After doing housework and making dinner it’s so fatigued (I’m only 42 lol) so I have to rest it and it’s frustrating. Trying to be patient. I bought the insoles and using KT tape too for when I’m not wearing shoes inside the house. I’ve been using a tens unit and massage tools too.

[@theaviatroy]

@@nicolemartin.NH-FL thank you for sharing! I hope you get well soon 💪

[@erinhawkins5984]

I was diagnosed with PTTD today and the advice you’ve given is so helpful. Thank you!

[@PhysioMSK]

You’re very welcome ☺️

[@inesnovo]

The best video I’ve seen on the subject, detailed and easy to comprehend with day to day examples. Thank you for your excellent work!

[@PhysioMSK]

You’re welcome. Thanks for taking the time to comment 🙏

[@nisbatmalik5961]

Thankyou! Went to see my podiatrist who wasnt any help..you were super helpful.great video.

[@PhysioMSK]

Thanks for the feedback. Glad it helped!

[@MsVee888]

I went to 4 and you gave much more information!!

[@maldub]

This was very helpful for this pttd victim. Thank you for taking the time to inform me.

[@PhysioMSK]

Thanks for the kind comment. I’m glad it helped. Best wishes. Stephen.

[@mick0880]

Thank you. This is super informative. I have flat feet and recently had surgery on my ankle (osteochondral lesion in the talar dome). Started PT 4 weeks ago and finally went back to work. Seemed like I overdid it the other day by walking a little more than I have been. This is exactly where the pain is. I hate having this set back but with your video and information, I feel a lot better and will mention this to my doctor when I see him next week.

[@PhysioMSK]

Thanks for taking the time to comment. Much appreciated. I hope it settles down quickly for you. Best wishes.

[@allisonwilliams2636]

Great video, well explained. Recovery timelines outlined and I now know I did too much too soon to get back to work and I wasn't exaggerating. Thanks for the comprehensive advice.

[@PhysioMSK]

Glad it was helpful!

[@puretranscending]

Thank you. I've watched a ton of videos and this was the most helpful and informative.

[@PhysioMSK]

Thanks. Nice of you to say so. Much appreciated. Best wishes. Stephen.

[@phoneasi]

I used to be a runner, but one day I experienced pain in that specific area. I visited a foot doctor who diagnosed me with (PTTD). Despite trying various treatments, the pain persisted until I started using an Aircast PTTD ankle brace, which helped improve the situation, although not completely. It has now been a year since the pain began, and while I can walk without any issues, the pain returns after long walks. Although I’m no longer limping and can walk without brace, I’ve transitioned to biking, but it’s not the same as running. Will my condition ever fully improve?”

[@PhysioMSK]

It depends on the health of the tendon. An MRI or ultrasound scan can determine that. However, in my experience the ones that plateau like this are often the ones that haven’t been through a thorough exercise / rehab programme. This is usually what’s needed in order to increase tendon strength and resilience and ultimately get it fully better.

[@LookSharpFeelSharpBeSharp]

Great video, no nonsense.

[@PhysioMSK]

Glad you liked it! Thanks for the feedback.

[@fosmert877]

This was an excellent video for this problem.

[@PhysioMSK]

Thanks. I appreciate the feedback.

[@TheDoomWizard]

Wonderful explanation

[@PhysioMSK]

Thanks 🙏

[@kelbee8974]

Very helpful & easy to understand

[@PhysioMSK]

Glad it was helpful!

[@waltseale]

Great video! Really needed it.

[@PhysioMSK]

Glad it was helpful!

[@MurielMetcalfe]

Fantastic helpful advice. Best ever. Thanks

[@PhysioMSK]

You’re welcome! Glad it was helpful.

[@shynetchivasa6536]

Thank you for the video. Have been anxious for I have a swollen inner ankle. I am now in the 2nd month of reduced weight.

[@PhysioMSK]

Keep up the good work 👍

[@Karettu]

Super helpful thank you very much I wish you the best

[@PhysioMSK]

You're very welcome! All the best to you too.

[@jessjane6765]

Very helpful video!

[@elvislady64]

Hi steven, great video very informative to me. I had foot pain for over 2 months. I think i can trace it back to just turning my ankle at work on my right foot. I didn't really think much of it. Over the weeks my foot got really painful walking. I ened up at podiatry who said I had PTTD. he gave me exercises to do after 2 weeks the pain was no better. Long story i went to my GP was sent for xray. And was diagnosed with Pes Planus. Reading up on this it says its PTTD? my question is the pain is on the outer of my foot along the line from where my little toe is not as far up as my toe. Round in to my foot on outside. It feels burning at times when I walk and its going round my ankle up the back of my foot and leg I dont feel it much in the inside if my foot. So I am confused. Is this PTTD. Just to say I am being referred to podiatry again on the NHS. to hopefully get the correct in soles.

[@PhysioMSK]

@@elvislady64 I can understand the confusion. Pes planus is essentially a flat foot, and one of the common causes is a weak tibialis posterior tendon (but there can be other causes - some are just congenital). So you might have a week but non painful tendon. Your pain will most likely be caused by the bones pinching against each other on the outside of your ankle / foot. It’s called lateral gutter impingement and it common in chronic pes planus, but you would need a X-ray or MRI to confirm. Arch support insoles should help. Surgery also has a role in some cases.

[@elvislady64]

@@PhysioMSK Thanks for your reply Steven. The x-ray confirmed the pes planus I may ask for a scan on my foot as it's so painful on the outside and the heel. I will await the podiatry appointment and take it from there. Thanks for replying. 😀

[@RonitAssam]

Very informative video sir .. I am watching from India ... ❤

[@PhysioMSK]

I’m glad you found it helpful. Best wishes.

[@RonitAssam]

@@PhysioMSK doc, I am facing this issue. Due to lack of knowledge, I first began to massage the area feeling tender pain there. Now I know that adequate resting and iceing can help recover.

[@RonitAssam]

​@@sunshine2629you can tie your feet with a band aid cramp band aid .... This will help... Take rest don't walk much... 1 month is the standard recovery time

[@palboytg1]

Any thoughts on compression socks? They seem to help manage the pain / bloodflow but Im unsure if it could cause any issues when used long term or consistently

[@waeladil1685]

I've been dealing with this tendon injury for two years now. It happened when I was bodybuilding, and the strain on my foot increased without my knowledge, causing swelling inside my ankle. Despite this, I couldn't rest due to continuous work, but I took many anti-inflammatory medications and used many physiotherapy devices. The situation hasn't improved; now, after two years, I have swelling and pain when walking and moving. Do you recommend that I start a rehabilitation and strengthening exercise program, or should I just rest? Please translate this into English.

[@PhysioMSK]

If it’s swollen and irritable then it’s needs resting. Easiest way is by using the orthotics. Once it has settled down then you can slowly start strengthening it again. The whole process is likely to take many months I’m afraid.

[@snowey.5960]

Hello,I’ve recently broken my ankle 4 months ago and now have this pain on the inside of my ankle I can run,jump and do one legged calf raises with mild pain but I’m not sure how long I should take a break for , for it to fully heal and get a better recovery

[@PhysioMSK]

I’m afraid I can’t possibly tell if you have PTTD from your description. These videos work on the assumption that you’ve been diagnosed elsewhere. You should get properly assessed.

[@joesr31]

the single leg heel raise for my injured foot it kinda "pops" into a weird position forward and then goes back in place midway when I'm going down, the popping is more pronounced if I try to push my ankles outwards (ie. knees turn slightly inwards) when coming down. Should I feel this way and continue doing it or is that bad and I should kinda stop right before that "popping" feeling on my way up

[@PhysioMSK]

Is the popping on the outside of your ankle ? If so, it might be a subluxing peroneal tendon. The inside ankle tendons can also sublux but less commonly. Either way, if it’s not painful then it’s best left alone.

[@decimojean328]

Hello doc, thank you for the video. Would you recommend the use of massage guns? i only got swelling.

[@PhysioMSK]

No I don’t recommend massage guns for any tendon problem. I would advice ICE, rest and consider anti inflammatory gel.

[@anitamurkes9511]

What to do if tefon is now weak ! Have been suggested foot surgery. Sounds like a tough operation. Do you know if these surgeries are succesful or are there any other treatments ?

[@PhysioMSK]

The whole video is about treatments other than surgery. Yes surgery can often be successful but it should always be considered a last resort option.

[@cymraesfalch]

Thank you for this advice. Unfortunately, four fays agoI was too energetic and persistent in doing stretches of my calves and ankles, and then an hour later i slipped/ rolled barefoot over the metal bar at the base of the stairgate. Ouch all round. Dwelling under the inner ankle. Cannot bear weight to walk. I have normal insteps, good footwear, orthotic insoles (neuroma), and have been icing, and wearing a support. How long does it take for pain and swelling to significantly decrease please. I'm assuming I wont need doctor got this ? Other sites seem to predict total flatfootedness for me in the near future .which I can't believe ! Any ideas ? Thank you.

[@PhysioMSK]

If it hasn’t improved significantly over 3-6 weeks then I would advise getting it looked at.

[@robertjaco1952]

My podiatrist said I have pttd because because my Arch has totally collapsed an overpronation. But there's not but there's never been no pain or swelling. Only time there's pain is when I overpronate too much

[@PhysioMSK]

I wouldn’t worry too much then. I would use an arch support to try and correct foot position and reduce the risk of developing secondary arthritis but that’s about it. The tendon has probably ruptured or is just very degenerative and no longer functioning but if you have no pain and you are managing well then it’s best left alone.

[@robertjaco1952]

@@PhysioMSK do you think Physical Therapy can help strengthen it if it's into that stage

[@PhysioMSK]

​​⁠Not if it’s ruptured. It might be worth getting an ultrasound or MRI scan so you can see the state of the tendon and whether there is any scope for improvement with rehab.

[@harisiosifidis1580]

Hi, Great video, I think I may have this however I do not get much pain in the tendon unless doing exercises such as; ankle bank stretches. Instead when walking, I get a lot of sole pain or pain on the left side of my foot, I am a bit confused on what this means, I can usually not feel the tendon at all, however my left foot is is definitely falling inwards as the photograph showed. Could you advice at all? Thank you.

[@PhysioMSK]

@@harisiosifidis1580 I would get an X-Ray. The most common cause of mid foot pain in a flat foot or low arch is osteoarthritis.

[@harisiosifidis1580]

Hello, is it the case even as a young adult (22), I recently found out I walked overpronately for some time (maybe due to a knee injury a physio said) and have tried to correct it myself. Is it possible that it could be muscles being used again hurting? It has been almost 2 months. Thank you.

[@PhysioMSK]

​​⁠yes it is quite possible. Unlikely arthritis in your age group. Try using a medial arch support insole and see what effect that has.

[@harisiosifidis1580]

Hello, thanks for your fast response, I can tell you're an amazing physio. I am seeing a physio and podiatrist soon, is there anything you think I should mention to get an accurate diagnosis? E.g. I only get pain after 20 mins of walking, it gets worse overtime, I used to get heel pain but it went away. Etc. Thank you!

[@PhysioMSK]

Yes that’s all useful information. They will want to know when it started, what you think might be the cause (any changes in your activities), where the pain is, what makes in better & worse, what treatments you’ve tried and their effect and any images or investigations. Also what type of footwear is most comfortable (show them) and what makes it worse. Just be honest. Best of luck with your treatment.

[@Sulita-u5o]

Thank you so much.

[@PhysioMSK]

You’re very welcome

[@shamsblitz]

Hello Sir, I went through your video and looks like i have the same problem in movement, and it's painful, my doctor referred this to synovitis after watching MRI, but I think it can also be PTT with synovitis, please share your thoughts and a good doctor/podiatrist in india/delhi

[@PhysioMSK]

Yes, PTTD can often be associated with a Tenosynovitis. I’m afraid I don’t know any clinicians in India though.

[@NPPREMA]

Thank you for this very well-explained info on PTT. I used to have intermittent mild pain in my inner ankle but after one aerobics session, it flared up and now I'm literally cooling my heels with ice packs and relative rest. I've purchased wearable medial arch supports and well, been prescribed a nutraceutical called Tendoheal and Vitamin C tablets

[@nicolastarsky]

Hello. Can I ask what the problem is if I can’t do a single leg toe rise? I had a navicular avulsion fracture few year ago. I have rheumatoid arthritis. Not getting any help and I can’t walk at moment

[@PhysioMSK]

You might have ruptured the tibialis posterior tendon. Or the tendon might have pulled off the navicular. This probably needs checking out with a scan.

[@nicolastarsky]

@@PhysioMSK thank you for your prompt answer. I’ll go today.

[@kyounao]

How about injections (steroids)for Posterior tibial tendinitis.

[@PhysioMSK]

For tendinitis (ie fluid seen in the tendon sheath on imaging) then yes, corticosteroid injection is an option but need appropriate reduction in activity to protect the tendon due to risk of rupture. If tendonopathy(ie degenerative tendon but no inflammation on imaging) then injection unlikely to be helpful in the long term. The latter is much more common in PTTD.

[@cherrytraveller5915]

Thanks to my boss being an awful person and forcing me back onto standing benches my tendon shredded to pieces. I am due to have surgery in a weeks time which I am terrified of.

[@PhysioMSK]

Best of luck with it !

[@jstepheny63]

Can This Be Caused From A Twisted Ankle Also?

[@PhysioMSK]

Trauma can cause a sprain or even a tear of the tib post tendon which can cause similar symptoms. If it then doesn’t heal then it can lead to PTTD.

[@dianecamilo4308]

Aircast pttd ankle brace airlift is fsntastick its the only way i can walk for now

[@PhysioMSK]

Yes they can be really helpful. I hope it settles down for you 🤞

[@kyounao]

How is your recovery? I personally have been having pain for 6 weeks. I purchased myself that PTTD boot myself waiting for it to come in.

[@oKima81]

I had a tibia and fibula fracture 5months ago, now i walk but i have a flat feet and pain amd swelling in the ankle.. what can i do ?

[@PhysioMSK]

You need a diagnosis first. It might be this condition or it might be something else. So go and see someone.

[@oKima81]

​@@PhysioMSKThank you so much, god bless you ❤️🙏

[@birdsnest4350]

Arches make it worse for me

[@ShanonKukula]

Me too

[@birdsnest4350]

15 years I’ve suffered been told were trainers full time…..I’m a woman….No chance

[@anitamurkes9511]

I’d be happy at this point if trainers would work. Also woman love beautiful shoes . Have to wear laced boots (right foot after injury)