Ankle & Foot
Posterior Tibial Tendon Dysfunction
Also called: Adult-acquired flatfoot
Failure of the tendon that holds up the inner arch, causing pain along the inner ankle and a progressively flattening foot. The critical fact: this is a progressive condition where early-stage treatment (loading, support) works well and late stages become structural — so 'my arch is falling' deserves prompt attention, not observation.
Common signs
- Pain and swelling along the inner ankle, behind the inner ankle bone
- The arch lowering; foot rolling inward
- 'Too many toes' visible from behind
- Unable to do a single-leg heel raise, or the heel doesn't swing inward when you try
Seek help now if
- Rapid arch collapse
- Numbness or vascular signs
- Inflammatory arthritis history with new tendon failure
If any of these is sudden or severe, call 911 or go to an emergency room. For the others, get examined before you start self-care.
What to do first
- Get staged now — the single-leg heel raise test is the key exam moment
- Early stages: arch support/orthotic plus a progressive tendon loading program is the proven combination
- Trim provocative load (long standing, uneven ground) while capacity is rebuilt
The longer road
- Committed conservative care over months halts most early-stage progression
- Track the heel-raise count monthly — your objective tendon meter
- Progressing deformity despite quality care: specialist consult; earlier stages have better options
Natural healing options we use
- Progressive posterior tibialis loading program
- Orthotic/arch-support strategy
- Manual therapy and chiropractic care for foot-ankle mechanics
- PEMF and attended e-stim; tendon-support nutrition
About imaging
Weight-bearing X-rays assess alignment; MRI/ultrasound grade the tendon when staging or surgery is in question.
Daily self-care
- Daily heel-raise progressions with attention to heel position
- Wear the support during loading hours
- Report visible arch change promptly
How we can help
Massage & Soft-Tissue Therapy
Learn more →Chiropractic Adjustments
Learn more →PEMF Therapy
Learn more →Neuro-Electrical Stimulation
Learn more →More in Ankle & Foot
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Please read: this page is education, not a diagnosis. A proper examination is how a condition gets confirmed and a plan gets built. See our medical disclaimer.