How to Prevent PTTD: Protect Your Posterior Tibial Tendon

While not all cases of posterior tibial tendon dysfunction can be prevented, there are proven strategies to reduce your risk and keep your feet healthy. Here’s what you can do to protect your posterior tibial tendon.

Who Is at Higher Risk?

Certain factors increase your likelihood of developing PTTD:

  • Age: Risk increases after 40
  • Gender: Women are more commonly affected
  • Obesity: Excess weight stresses the tendon
  • Flat feet: Pre-existing flatfoot deformity
  • High-impact activities: Running, jumping sports
  • Diabetes or hypertension: These conditions affect tendon health

If you fall into any of these categories, prevention becomes even more important.

Choose the Right Footwear

Your shoes play a crucial role in tendon health:

Do:

  • Wear supportive shoes with good arch support
  • Choose motion-control or stability shoes if you overpronate
  • Replace athletic shoes every 300-500 miles
  • Consider custom orthotics if recommended by a podiatrist

Don’t:

  • Rely on flimsy flip-flops or sandals for daily wear
  • Wear worn-out shoes that have lost their support
  • Choose fashion over function in everyday footwear

Exercise Smartly

Proper exercise habits protect your tendons:

  • Warm up thoroughly before any physical activity
  • Increase intensity gradually — avoid sudden training spikes
  • Cross-train with low-impact activities like swimming or cycling
  • Incorporate strength training for foot and ankle muscles
  • Stretch regularly, focusing on calves and Achilles tendon

Maintain a Healthy Weight

Excess body weight significantly increases stress on your posterior tibial tendon with every step. Even modest weight loss can dramatically reduce your risk. If you’re overweight, consult with your doctor about a realistic weight management plan.

Address Foot Problems Early

Early intervention matters:

  • Get evaluated if you have flat feet or overpronation
  • See a podiatrist for persistent ankle or foot pain
  • Don’t ignore early symptoms like inner ankle swelling or pain
  • Consider preventive orthotics if recommended

Build a Prevention Routine

Daily habits that help:

  1. Calf stretches: Hold for 30 seconds, repeat 3 times daily
  2. Ankle circles: 10 rotations each direction, daily
  3. Toe curls: Pick up marbles or a towel with your toes
  4. Self-massage: Roll your foot over a tennis ball
  5. Foot checks: Look for swelling or changes in foot shape

When to See a Doctor

Seek professional evaluation if you experience:

  • Persistent pain along the inner ankle or arch
  • Swelling or redness around the tendon
  • Difficulty walking or standing on tiptoes
  • A collapsing arch or flatfoot development
  • Pain that worsens with activity

Early treatment of minor tendon issues can prevent progression to full-blown PTTD.

The Bottom Line

Preventing PTTD is largely about being mindful of foot health, wearing supportive footwear, maintaining a healthy weight, and addressing problems early. If you’re at higher risk, these strategies become even more critical. Your feet carry you through life — taking care of them now can save you significant pain and limitations down the road.