Patient discusses her treatment for stage II posterior tibial tendon dysfunction (PTTD) using the Richie Brace AFO. www.richiebrace.com Posterior Tibial Tendon Dysfunction (PTTD) is a painful flatfoot condition which affects adults, primarily over the age of 50. Also known as Adult Acquired Flatfoot, this pathology affects women more than men and is linked to obesity, hypertension and diabetes. Most people with PTTD have had flat feet all of their lives. Then, for reasons not fully understood, one foot starts to become painful and more deformed. PTTD begins with a gradual stretching and loss of strength of the posterior tibial tendon which is the most important tendon supporting the arch of the human foot. Left untreated, this tendon will continue to lengthen and eventually rupture, leading to a progressive visible collapse of the arch of the foot. In the early stages, patients with PTTD will notice a pain and swelling along the inner ankle and arch. Many times, they are diagnosed with "tendonitis" of the inner ankle. If the foot and ankle are not properly supported during this early phase, the posterior tibial tendon can rupture and devastating consequences will occur to the foot and ankle structure. The progressive adult acquired flatfoot deformity will cause the heel to roll inward in a "valgus" or pronated direction while the forefoot will rotate outward causing a "duckfooted" walking pattern. Eventually, significant arthritis can occur in the joints of the foot, the ...
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