Once diagnosed with Posterior Tibial Tendon Dysfunction as
evidenced by the “too many toes” sign and the heel rise test, there are some
conservative treatments available to help support or slow the progression of
the condition. The best treatment for you
will depend on how far advanced you are with the disorder.
If caught far enough in advance, minor modifications can be
made to shoe gear to help reduce the amount of pronation. Custom orthotics made from plaster molds can
be fashioned to give support to the arch.
Modifications can be made to the orthotics with time. If pain persists, a steroid shot can be
given to help decrease inflammation.
The decision to go ahead with a shot must be carefully considered as steroids
can weaken ligaments and cause the condition to progress faster. Oral steroids or anti-inflammatory medication
may provide some relief, but will not reverse or halt the progression.
In most cases, orthotics will not provide enough
relief. In many instances, orthotics are
skipped as a treatment and the doctor will recommend a custom ankle brace as
the primary treatment. Similar to
orthotics, you will be casted for the brace, which will then be sent off to a
lab for fabrication. There are many variations
to this brace, and they will be fabricated slightly different. This brace laces up the
front, extends up around the ankle, and fits into most shoes. It helps to give support to the arch and
foot. Movement of the joints in the foot
is minimized, thus reducing pain and swelling.
If worn consistently, this brace can be a definitive treatment for some
individuals. However, the brace can be
bulky and difficult to wear during the warm summer months.
