When it comes to foot biomechanics or posterior tibial tendon dysfunction, there are a lot of conflicting opinions online. The height of the foot arch is often at the center of the debate: is it responsible for the development of our pain?<\/p>\n
As with any scientific question, the answer is more complex than a simple \u201cyes\u201d or \u201cno.\u201d<\/p>\n
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When a professional assesses the function of the foot and lower limb, they observe both its appearance and how it moves. Many people tend to blame the shape of the foot (the ideal \u201cscapegoat\u201d) or the way it supports the body as the cause of pain.<\/p>\n
However, it is crucial to distinguish between natural morphological variation and a true pathology. The latter leads to changes or progressive weakening, including a collapse of the arch.<\/p>\n
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That is why regular check-ups with a qualified professional can help ensure that no treatment is needed and allow for early detection if any changes or deterioration occur.<\/p>\n
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The short answer :<\/strong> A low arch isn’t necessarily a problem.<\/p>\n <\/p>\n <\/p>\n Posterior Tibial Tendon Dysfunction (increasingly referred to as Progressive Flatfoot Deformity) is a condition in which the tendon, along with other supporting structures, becomes irritated and weakens. This process gradually alters the way the foot bears weight during walking.<\/p>\n <\/p>\n <\/p>\n Clinically, DTTP is classified into stages. Early stages are often reversible and treatable. More advanced stages, which involve greater stiffness, are generally managed to stabilize symptoms and prevent further deterioration.<\/p>\n Without appropriate intervention, the loss of arch height often becomes difficult to restore. That said, the tissues can be strengthened to better tolerate weight-bearing, thereby creating a \u201cnew normal\u201d for the foot and lower limb.<\/p>\n If the posterior tibial tendon were to fail completely, movements such as standing on tiptoes with control could be seriously compromised, affecting foot stability, the foot\u2019s ability to act as a stable lever during the push-off phase, and weight transfer while walking.<\/p>\n <\/p>\n In some cases, surgical reconstruction may be necessary to restore control of the hindfoot.<\/p>\n <\/p>\n <\/p>\n These simple screening tests can help you determine whether you need to see a professional:<\/p>\n <\/p>\n 1. Bilateral heel raises <\/strong>: Stand on your tiptoes while holding onto a wall, and assess how smooth the movement is. If this is difficult, try repeating the test on one foot at a time to compare the sides.<\/p>\n 2. Single-leg raise :<\/strong> Try standing on one foot at a time. Note if one side feels weaker, less controlled, or more painful than the other.<\/p>\n <\/p>\n Please keep in mind, however, that these tests do not provide a diagnosis but serve as an indicator of whether you should seek medical advice.<\/p>\n <\/p>\n <\/p>\n It\u2019s important to clarify that manual therapy does not \u201cput things back in place,\u201d contrary to some claims you might find online. It acts as a lever to help muscles and tissues function better and to reduce the perception of pain. This can make movements more fluid, reduce the \u201cknotted\u201d sensation you may be experiencing, and facilitate your participation in the rehabilitation process.<\/p>\n <\/p>\n As osteopaths, we can collaborate through interdisciplinary approaches, particularly to:<\/p>\n <\/p>\n <\/p>\n It is generally recommended that you see a qualified professional as soon as possible. Seek medical advice if you experience:<\/p>\n <\/p>\nWhat is the PTTD?\u00a0<\/strong><\/h3>\n
Signs and symptoms to watch for:<\/h4>\n
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Progress and prognosis :\u00a0<\/strong><\/h4>\n
What you can check at home<\/strong><\/h3>\n
The Benefits of Manual Therapy and Interdisciplinary Care<\/strong><\/h3>\n
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When should you see a professional?<\/strong><\/h3>\n