During my search to help cure my plantar fasciitis, which seems to have come back with a vengeance since I have started going to the gym more regularly, it lead me to discover another condition that seems very similar.
If you are getting pain around the back of your ankle and also across the top of your foot, radiating underneath too, you could have Posterior Tibial Tendonitis or Dysfunction (PTTD).
As with Plantar Fasciitis, this injury is caused by the inflammation of the tendon, whose job is to keep the arch of your foot up and your foot straight.
Again, as with Plantar Fasciitis and other tendon/fascia related foot problems, the most likely cause of PTTD is either from overuse or injury. It can also be affected or caused by wearing a poor choice of supportive shoe.
“Overuse of the posterior tibial tendon is often the cause of PTTD. In fact, the symptoms usually occur after activities that involve the tendon, such as running, walking, hiking or climbing stairs.”Source: FootHealthFacts.org
However, having the right shoes for PTTD can help fix this problem and stop your heel and foot pains.When you have this issue, it causes the foot to “supinate” or fall inwards on the ankle.
And when this happens too much or too often, the posterior tibial tendon running up the back of your foot and ankle, will try to stop it from doing so causing it to become inflamed or even rupture completely.
“Supination is considered natural for some people, but it places extra stress on your foot and leg that can cause problems elsewhere. That’s because the shockwave from your heel strike isn’t absorbed properly and the outside of your foot bears the full force of your step’s impact.”Source: FootSmart.com
What are the best shoes for posterior tibial tendonitis?
To stop PTTD and the additional pronation of your foot (falling inwards on the ankle) the best long-term solution is to have shoes with orthotic inserts or buy footwear that is designed to prevent pronation.
Luckily, these kinds of shoes are readily available, so let’s look at the top shoes for men and women with PTTD.
My pick of the best shoe for men with PTTD: ASICS Men’s GT-1000 5 Running Shoe
- Impact Guidance System (I.G.S) (Running) : ASICS...
- Rearfoot and Forefoot GEL Cushioning Systems:...
- SpEVA Midsole: Material Improves bounce-back...
- Guidance Line: Vertical flex groove decouples...
This ASICS running shoe (also available in pure black colors) has the exact properties sufferers of PTTD are looking for.
The GT-1000 have a good firm mid-sole and have been designed to prevent pronation, keeping the ankle straight and supported when walking and running.
Gel support insole.
ASICS have also added gel support inside too, which will help absorb any impact that might hurt your feet whilst you are recovering from foot and heel pain.
Many people have commented how comfortable they are with great cushioning and support – perfect for those of us with bad feet.
The shoes have been designed from synthetic materials so they are not too heavy to wear, making the great if you want to exercise in them or just go for a walk.
They are also not too large or cumbersome to wear around the house during the day – something that might help reduce any PTTD pain.
These shoes (version 5) are an improvement on a previous model and have been redesigned to be less bulky and weigh less.
They come in larger sizes.
The GT-1000 ASICS shoes come in a good range of widths and sizes, so they are perfect if you have very large feet, going up to a size 17 4E.
However, like many shoes, if you have wider feet, you might want to buy a half-size larger as this can often fit better.
Some people who have already bought this shoe have mentioned that they can be a little tight in places, so going for a slightly larger size might be a good idea.
My choice of the best shoe for women with PTTD: Saucony Redeemer ISO
- Running shoe for severe overpronators featuring...
- PWRGRID+ midsole
- IPR+ rubber outsole
- Accomodates orthotics
Unfortunately, the top women’s shoe for posterior tibial tendonitis does leave a little to be desired in the looks department (unless you like bright colors) but if you are ok with wearing a trainer type shoe all the time, then these are ideal.
Due to the additional support these shoes have, some people think they look a bit “clunky” – but you will get this with many shoes that are designed to stop pronation.
Saucony are well known for producing great running shoes and they have added additional midsole support to the Redeemer ISO.
They have called this their “TPU Pillars” which will help stop pronation, which will help prevent PTTD.
Similar to the ASICS shoe I reviewed for the men with posterior tibial tendonitis, the Redeemer shoe has also been improved over multiple versions.
This model has the “Saucony PWRGRID+ cushioning system” which has been made 20% better than the previous model.
What does this mean for you? Better support, comfort, impact reduction and protection when you walk or run.
Having a shoe with good support and comfort is ideal when dealing with painful feet.
I really love this feature and wish that other companies would be more accommodating where people want to use their own custom orthotics.
Most running shoes do come with some sort of supportive innersole, but if you are using orthotics, these are usually removed and replaced with your own. The problem being that they might not fit very well.
The Redeemer ISO shoe has been designed with a slightly wider fit, to allow you to use your own orthotics. If you already have custom orthotics to help with your PTTD, the additional support these shoes give will make an ideal combination.
What to look for when buying the best shoes for PTTD.
- A shoe where the mid-sole area is firm and cannot be easily twisted or rotated.
- A shoe that provides good heel support, also to stop pronation.
- The shoe offers good cushioning inside.
- Shoes that allow you to use your own orthotics if needed.
- A shoe that stops “breakdown” on the inside, meaning it has more support around the arch.
- A shoe that has “motion control” or “maximum stability” features as these prevent midsole twisting and pronation.
One point I need to make is that there are not many normal day-to-day shoes that offer these features. You are more likely to find them in running or walking shoes.
This does narrow down the list of options a little, but if you are serious about treating this condition, you might have to forgo the way the shoes look.
How do I know if I have PTTD?
Because PTTD can be very similar to other foot and ankle problems such as Plantar Fasciitis, it is important that you get proper advice and diagnosis.
First, start by reading What is PTTD? by the American College of Foot and Ankle Surgeons and then take a look at this video from Dr. Matthew Neuhaus of Neuhaus Foot and Ankle which accurately describes the causes, symptoms and possible treatments for PTTD.
You can use these 2 excellent resources as a guide to help see if your foot pains are similar.
Unfortunately, there are not many shoe types that cater directly to help solve this painful problem, although choosing a shoe with good mid-sole and heel support will be the best option if you can’t find exactly what you are looking for.
The best shoe for PTTD may simply be a good, supportive running shoe or a walking boot.
Following our buying tips will help you find the best footwear for this nasty, painful affliction.
Medical sources about PTTD.
This is a list of the sites and information I used to create this article.
- Supination. Foot Smart. https://www.footsmart.com/health-resource-center/foot/supination. Accessed October 14, 2018.
- Posterior Tibial Tendon Dysfunction (PTTD). ACFAS. https://www.acfas.org/footankleinfo/pttd.htm. Accessed October 14, 2018.
- Podiatrist Nashville TN. Neuhaus Foot and Ankle. https://www.neufoot.com/. Accessed October 14, 2018.Posterior Tibial Tendon Dysfunction (PTTD).
- Foot Health Facts. https://www.foothealthfacts.org/conditions/posterior-tibial-tendon-dysfunction-(pttd). Accessed October 14, 2018.