This article will talk about the different physical therapy exercises that are used to treat PTT dysfunction.
Physical Therapy for PTT
Posterior tibial tendon dysfunction (PTT) makes the inner part of your foot or ankle hurt. The pain can make it harder for you to walk or run. Working with a physical therapist can help make the pain better so you can get back to your usual activities.
The goals of therapy for PTT dysfunction are:
Helping the foot and ankle move without pain Improving foot and ankle range of motion Making the foot and ankle stronger Improving foot position with exercise or special shoe cushions called orthotics Helping you return to your normal level of functioning
Your physical therapist can use different techniques to help you. For example, they may use:
Manual techniques Therapeutic modalities Kinesiology taping Exercises
Exercises should be the focus of your physical therapy program. Research has shown that specific exercises are a good way to treat PTT. The key is knowing which exercises to do and when to do them. Your physical therapist will help you figure out the best exercise program for your condition.
Before you start doing exercises for PTT dysfunction, talk to your doctor. They can make sure that it’s safe for you to start doing them.
Ankle ROM exercises can be active or passive. Passive ROM exercises mean that your therapist will be moving your foot and ankle for you. You do nothing during passive ROM exercises.
Active ankle ROM exercise includes four directions of motion:
Pulling your toes and ankle up (dorsiflexion)Pointing your toes and ankle down (plantarflexion)Moving your foot and ankle inwards (inversion)Moving your foot and ankle to the side and away from the midline of your body (eversion)
Ankle ROM exercises for PTT dysfunction should not hurt. If you feel pain when doing the exercises, stop and tell your physical therapist.
Runner’s stretch Towel ankle stretch Hamstring stretches Anterior tibialis stretches
Do these stretches for three reps, holding them for 30 seconds each (work up to this if you need to). You can do them several times a day.
Flexibility exercises for PTT dysfunction help the muscles around your foot and ankle move better. They also help make sure your feet are lined up the right way when you’re walking and running.
If your feet or ankles hurt when you do these exercises, stop and tell your physical therapist.
One of the easiest ways to strengthen your ankles is with a latex rubber band called a resistance band. You wrap the band around your foot to create resistance as you move.
Here are a few exercises you can do with resistance bands:
Ankle inversionAnkle eversionAnke dorsiflexionAnkle plantarflexion
Doing these exercises should not hurt. However, they will make your ankle and foot feel a little tired.
If the exercises are easy, you can make them more challenging by using a thicker band. Doubling up a resistance band can also increase the tension.
You can also do exercises to make the muscles in your feet stronger. This supports the natural arch in your foot, which takes the pressure off your injured tendon.
Foot exercises have you use your toes like you would use your fingers. Here are a few examples:
Scrunching up a towel with your toesPicking up a tissue with your toesPulling your toes against a light resistance band
Foot and ankle exercises can be done for eight to 20 repetitions, several times a week.
Here are some examples of exercises that can make your hips stronger:
The bridge The single-leg bridge Theraband hip strengthening Hip hikes Straight leg raises in various directions
Exercises for the muscles around your knees focus on your quadriceps and hamstrings. Here are a few examples of knee-strengthening exercises:
Short arc quads Squats Lunges Straight leg raises
Do these exercises for eight to 15 repetitions. Move slowly through the full movement. If any exercise hurts, stop and check in with your physical therapist.
Better balance and awareness of the position of your foot and ankle can decrease the stress on your injured tendon.
Balance exercises can start out simple, like a single-leg stance progression. More advanced exercises could be standing on a foam pad with one foot and catching a ball. You could also stand on the pad and squat down slowly.
Your physical therapist might use tools to make the exercises work better for you. Here are a few examples of tools you might use:
BAPS board BOSU ball Wobble board or ROCK board
Balance exercises should be done slowly and with control. Don’t worry if they are hard to do at first. Try not to get discouraged if you don’t see results right away. It can take a few weeks to see improvement.
Your physical therapist may include plyometric exercise as part of your posterior tibial tendonitis rehab. If you are an athlete trying to get back to playing pain-free, this type of training will be important.
Your physical therapist will likely wait until later in your rehab to start plyometric training. You need to have very good strength, balance, and proprioception to handle the forces it puts on your body.
Examples of plyometric exercises include:
Drop jump Single leg hopping Hopping or jumping in different planes of motion and directions
Be careful when you’re doing plyometric training. Your body needs to always be in the proper position while you are exercising to prevent injury.
Your physical therapist can watch you do the exercises and make sure you’re doing them the right way.
These movements will be specific to your needs. For example, if PTT dysfunction is keeping you from running or participating in a sport, then your therapist will gear the exercises to that sport.
As you return to your normal activities, you might notice that your symptoms come back a little bit. Doing too much too soon could undo the gains you’ve made.
You’ll need to ease back into your regular activities. Your physical therapist will guide you and make sure you’re progressing at a safe rate.
Summary
PTT dysfunction can be treated with physical therapy exercises. The focus of a physical therapy program for PTT is on the feet and ankles.
Range of motion exercises and stretching help keep the muscles in your feet and ankles strong. These exercises support the other muscle groups that keep your lower body in the right position. It’s also important to improve your balance.
A Word From Verywell
Foot and ankle pain from posterior tibial tendonitis (PTT) dysfunction can keep you from taking part in your normal activities.
Most cases of PTT dysfunction can be treated with physical therapy. Exercises that help your ankle and foot move and function better are a key part of rehab for PTT. If you have foot and ankle pain, working with a physical therapist can help you get back to your favorite activities without pain.
However, if you don’t notice improvement after six to eight weeks of therapy, you might need to have other treatments. You may need cortisone injections or surgery to fix PTT.
