Start with understanding
The posterior tibial tendon helps support the arch and foot during walking. Problems involving it can bring pain around the inside of the ankle, difficulty pushing off, or changes in foot function.
Progressive collapsing foot deformity is a broader, complex condition involving several supporting structures. Not every flat foot has tendon dysfunction, and foot shape alone does not tell you which treatment is needed.
Video coming soon
Explore the written guide and illustrated lessons below.
Connect understanding to daily life
Notice change rather than judging shape
Tell your clinician whether the concern is new, whether one foot differs from the other, and what activities have become difficult. A changing arch, inner-ankle discomfort, or loss of comfortable walking can be useful observations. They do not identify the diagnosis by themselves. Avoid assuming a lifelong low arch is a problem simply because an online image shows a different foot.
The tendon is part of a support system
AAOS explains that tendons and ligaments both contribute to arch support and that progressive collapse can involve more than the posterior tibial tendon. Ask which structures and stage your provider believes are relevant. This distinction helps explain why the same insert or exercise is not the answer for every foot. A plan should fit your symptoms, examination, and degree of change.
Support and rehabilitation can work together
Orthoses, bracing, and an appropriate rehabilitation plan may be options, especially earlier in the condition. A small randomized trial found improvement with orthoses and stretching, with additional benefits in exercise groups. That does not establish a universal exercise recipe. Ask how support and loading fit together in your plan and what response should guide the next adjustment.
Make walking goals practical
Describe the walking your day requires: a work shift, errands, or a route you enjoy. Ask whether you should temporarily change the distance, surface, or footwear while the condition is assessed and managed. Use one repeatable activity as a review marker. Your ability to participate matters more than repeatedly inspecting whether the arch looks exactly like a model image.
Review change early
Arrange assessment for a newly changing foot shape, persistent inner-ankle pain, or worsening walking ability. If the plan is not helping, ask whether the diagnosis, support, or specialist involvement should be revisited. Some situations require a surgical opinion; needing one is not a failure of effort. You should understand the options, their goals, and the reasons behind each recommendation.
Educational information complements individual guidance. Your health history, goals, and examination determine appropriate care.
Build your understanding
Five ideas to build your understanding. Swipe, use the arrows, or focus the slides and use your keyboard.
Does a flat foot mean I have PTTD?
No. Foot shape alone does not establish tendon dysfunction or progressive collapse. New symptoms and changes deserve an assessment.
Can exercises reverse every stage?
No. Evidence from early-stage programs cannot be applied to every deformity. Your clinician should explain which options fit the stage and findings.
What the evidence means for you
The newer terminology reflects complexity
AAOS describes progressive collapsing foot deformity as involving tendon, ligament, and structural changes.
Put it to use: Ask whether your concern involves a tendon problem, a broader deformity, or another explanation.
Keep in mind: The overview cannot stage your foot or establish a diagnosis from appearance.
American Academy of Orthopaedic Surgeons →Early-stage care can combine support and exercise
A trial of 36 adults with stage I or II problems found improvement with orthoses and stretching, with further benefit in resistive-exercise groups.
Put it to use: Discuss a tailored combination rather than relying on one device or an unassessed exercise.
Keep in mind: This small, older trial does not establish the best program or support advanced-stage care.
Kulig and colleagues, Physical Therapy, 2009 →