A nagging ache on the inside of your ankle that flares up after a long walk or a day on your feet might be more than simple soreness. Posterior tibial tendon dysfunction (PTTD), also known as acquired adult flatfoot, is one of the most common reasons adults — especially women over 40 — develop progressive arch collapse, swelling, and pain that worsens without proper care.
At Sweeney Foot & Ankle Specialists, Dr. D. Sean Sweeney, DPM, FACFAS, and Dr. Christy Leahey, DPM, FACFAS, bring more than 20 years of trusted experience treating complex tendon and arch conditions across The Woodlands and Magnolia. Voted Best Podiatrist in The Woodlands by Living Magazine every year since 2012, the practice manages sports injuries with compassionate care and advanced technology to keep patients active and pain-free.
What Is Posterior Tibial Tendon Dysfunction?
The posterior tibial tendon is the main support structure for the arch of your foot. When it weakens, stretches, or tears, the arch gradually collapses, and the heel tilts outward. Because nothing else can fully replace this tendon, the deformity tends to worsen over time without treatment.
PTTD most often affects middle-aged and older adults — women four times more often than men — and is closely linked to risk factors such as:
- Pre-existing flat feet
- Diabetes and hypertension
- Obesity and increased load on the arch
- Age-related decrease in tendon blood supply
Recognizing the Symptoms and Stages
PTTD typically progresses through three stages, and earlier intervention produces better outcomes:
- Stage I: Pain, swelling, and inflammation along the inside of the ankle.
- Stage II: Visible flattening of the arch and outward rotation of the foot — still flexible and correctable.
- Stage III: A rigid, painful deformity, often with discomfort moving to the outside of the ankle.
How PTTD Is Diagnosed
Diagnosis relies most on a careful, hands-on evaluation by an experienced foot and ankle specialist. Gait observation, strength testing, and the single-foot heel-rise test help confirm whether the tendon is functioning properly. X-rays, MRI, or ultrasound may be ordered when imaging is needed to clarify the extent of tendon and ligament damage.
Treatment Options
Treatment is tailored to the stage of the condition and the patient’s overall goals. Conservative care is highly effective when PTTD is caught early.
- Rest, immobilization, and anti-inflammatory therapy for acute pain
- Custom orthotics to stabilize the arch and offload the tendon
- Ankle-foot orthotics such as the Richie, Arizona, or gauntlet brace
- MLS Laser Therapy to reduce pain and inflammation while accelerating tissue repair
- In-office physical therapy to rebuild strength and balance
- Surgery — including tendon repair, transfer, osteotomy, or fusion — when conservative measures are not enough
Why Choose Sweeney Foot & Ankle Specialists for Posterior Tibial Tendon Dysfunction in The Woodlands, TX?
Patients across The Woodlands and Magnolia choose Sweeney Foot & Ankle Specialists because the practice blends decades of clinical expertise with leading-edge, technology-driven care. Dr. Sweeney and Dr. Leahey take time to evaluate every contributing factor — from gait mechanics to lifestyle — and design personalized plans that prioritize non-surgical solutions whenever possible.
Combined with prompt scheduling for urgent concerns and a patient-centered approach rooted in compassion and integrity, it is no surprise the practice has been voted Best Podiatrist in The Woodlands every year since 2012.
Take the Next Step Toward Pain-Free Movement
Early treatment of posterior tibial tendon dysfunction can stop the deformity from progressing and help you stay active without daily pain. Schedule a consultation with Sweeney Foot & Ankle Specialists in The Woodlands at (281) 292-4944 or in Magnolia at (281) 789-4956 to build a personalized plan that restores your comfort, stability, and confidence on your feet.