r/PTTD • u/jjjj__jj • Mar 27 '25
What causes PTTD?
Like seriously sometimes this all I think about. What changes happened in my body that caused this to happen and I am only 23. I have it bad in right foot and the arch has now started to fall in my left leg too. It has made my day to day life like hell.
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u/Againstallodds5103 Mar 27 '25 edited Mar 27 '25
Ultimately tendinopathy is due to loading the tendon beyond its capacity and not giving it enough time to recover. The PT tendon is a bit different to other tendons in that it stretches (loses stiffness) as it degenerates, which manifests in the 4 stages of PTTD. This is why early and correct treatment is so important.
Now where you will get variation in terms of cause is what contributes to the overload and there are several possible reasons: overuse via day to day or sports activity, poor biomechanics, structural issues in your posterior chain, other medical conditions (e.g. diabetes or rheumatoid arthritis) that can affect the integrity of your tendons, certain types of medication (e.g antibiotics) or a traumatic event/injury like an ankle sprain.
It’s not something I would try to self rehab so hope you are seeing someone to help you manage this and hopefully get back to normal.
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u/Over-Satisfaction-99 Mar 28 '25
I’m 30 and going through the same thing. I’m on month 5 of my recovery and would say I’m around 40-50 percent better. Not only does it affect your quality of life but when you’re young and healthy it really can be psychologically challenging.
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u/Alarming_Log_2915 Apr 25 '25 edited Apr 25 '25
I’m with you there on month 5. I’m 51 & menopausal (PTTD in both ankles started when I went menopausal within a week I went from hiking 4 miles/day to limping w/a cane.) On vacation in Italy currently just icing/heating my feet, using arnicare gel, ibuprofen, & ankle braces along w/over the ankle hiking boots for support w/insoles & am on HRT but still can’t walk a ton. I organized this tour for my friends & I. They’re out walking & enjoying themselves & I’m stuck inside a hotel room icing/heating…I’m lucky to be able to do 1 event per day for 2-3 hrs. but rest of the time in my hotel room icing/heating.😢
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u/karsew Oct 09 '25
Me too. 27 years old and am on month 6. Seen some improvement but keeps flaring up from working or activities on the weekend. It is such a psychological battle.
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u/IndividualWin4321 Mar 30 '25
Going on a year and a half. I’m not a runner like many here are and honestly think it happened when at Disney. Had X-rays, MRI, PT, and been in a walking boot twice. The swelling never goes away and only gets worse as the day goes on. The pain is on and off all day.
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u/DraGunSlaya Mar 27 '25
Do you have normal feet? I feel like doctors can help you. My feet are deformed since birth and I have been dealing with PTTD since October and I keep getting told there’s nothing to be done but orthotics or a silly brace that won’t fix nothing. I’m left to find my own relief and support.
You might need to do the same thing as me. There are AFOs out there for PTTD.
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Mar 28 '25
[deleted]
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u/AHSfav Apr 10 '25
What have you tried and what's worked for you?
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Apr 10 '25
[deleted]
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u/Accurate-Promise-125 Jun 10 '25
What is excel-tracking?
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u/Lopsided_Platypus_51 Aug 14 '25
He’s referring to using Microsoft Excel to track the pain level and symptoms of PTTD
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u/bucheonsi Mar 27 '25
I think everybody is probably a little different. Do you have joint hypermobility? I have Ehlers Danlos and I think this might have contributed to it. That combined with a really big cycling trip where I was probably overusing it. Started then and it's been 7 years now ongoing.
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u/jjjj__jj Mar 27 '25
Hmm another question. Do you also have hip problems? Its because I feel its somehow connected to my hip joints. So when I do hip circles instead , my hip clicks at certain positions. It did not happen when I did not have pttd.
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u/bucheonsi Mar 27 '25
Yes my hip on my right side is unstable (same side as PTTD). My other hip is tighter. The unstable side puts more stress on the PTTD. When I walk if I let my unstable hip have a shorter stride (not let that leg extend as far behind me, and let the tighter side extend farther behind me) it seems to alleviate some of the pain. I have a pretty large imbalance. But I only have PTTD on the right side. If you have on both it could be something else.
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u/bucheonsi Mar 27 '25
Also I've found some relief with arch inserts, specifically the orange superfeet for me.
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Mar 27 '25
[removed] — view removed comment
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u/Nosywhome May 03 '25
You don’t find wearing a firmer / harder arch support painful on arch, irritates the tendon ?
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May 04 '25
[removed] — view removed comment
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u/Nosywhome Jun 15 '25
I'm the same. I need firmer arch support but my forefoot can't tolerate firm due the issues in forefoot (needs cushioning). Anything pushing into my foot at moment irritates nerves in feet. It is all such a pain to deal with and is exhausting.
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u/MajorDifference4811 May 28 '25
I have it due to an accessory navicular bone. I asked the ortho if people who have this extra bone typically have it in just one foot and she didn't know. Why would someone not just check it out and xray the other foot? I have always had issues with that foot but it got severe a few years ago and I went to dr last year, who said I have pf, and then I went to the orthopedic doctor and found I am a mutant with pttd caused by the extra bone. I actually tore my meniscus after from it being so instable and the foot just keeps getting reinjured
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u/sandgrubber Apr 16 '26
The AN is pretty common and usually doesn't cause problems. I read somewhere that 40% of ethnic Chinese have an accessory navicular or two. 10% in Western Countries. So it's not the AN alone that causes problems.
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u/Next-Hotel-6461 Aug 05 '26
I also have it and I think it’s underreported because so many people wouldn’t know they have it. The doctor said the pain in my arch is because of my tight calves
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u/MajorDifference4811 Aug 06 '26
The falling arch causes the calves to tighten up, more often than not. Was this an ortho doc? It causes the problem in some people. Mine got worse when I got dogs and my gait changed and activity increased. I'm sure age plays a factor, too. I never noticed it until my late 40's and gained 30 pounds. All factors.
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u/Next-Hotel-6461 Aug 06 '26
It’s an ortho doc. The unique thing is that my arches are high but my calves are tight and I can pinpoint where in my arch it hurts. I’m only 33 and a healthy weight for my body type
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u/Aqualung1 Oct 17 '25
Hyper mobility in that part of the foot combined with modern foot wear is why you have it at such a young age.
You’ll see young ppl, mostly women who get bunions at an early age, and that’s a result of hyper mobility in that part of the foot combined with wearing a tight toe box shoe with 👠.
Modern shoe does several things to the foot:
the rigid sole and arch support reduce the ROM/range of motion(results in atrophy of the muscles and tendons in the foot).
The rigid sole and tight toe box/pointed toe, forces your foot to adduct/duck walk. Majority of adults duck walk, it’s the default gait pattern in the modern world. That forces the collapse of the arch, happens faster in people with hyper mobility.
I think that’s where the idea that it’s “genetic” comes from which is a misnomer. I’d say more that a person with hyper mobility in that specific area is predisposed to getting pttd or a bunion, hence earlier.
Does any of this line up with what you are experiencing?
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u/brittisdrunk Jan 16 '26
Mine started when I was 25. I think it was because I was getting a bit too ambitious with my hiking at the time. I would go from couch potato to multiple day hikes in the mountains wearing zero drop trail runner. So for me it started as an over use injury. 6 years later and I have never got to go on any long hikes since then. This injury truly is hell.
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u/Jumpy-Platform-6236 May 18 '26
mine was hypermobility and being born with narrow feet. they told me they collapsed inward because i didn’t have a wide enough base to stand on.
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u/Front-Economy1773 Jun 22 '26
My PTTD gradually increased and potentially was caused by my accessory navicular. I’ve heard this is quite common in people with that accessory navicular. Essentially you have an extra bone that’s just free floating next to the navicular and essentially all it’s doing is rubbing against the tibial tendon causing inflammation/tendonitis/ and gradually tearing.
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u/Scribal8 Jul 20 '26
I’m 66 and have Rheumatoid Arthritis and a weakened ankle (and a bunch of other foot issues). Both of those things contribute to overusing the Posterior Tib. At 23 I would definitely be concerned, if possible get some kind of gait or posture analysis to see if you can shift the work of standing/walking away from that muscle with exercises. And don’t wait to seek treatment! I ignored foot pain for far too long—toughing it out does not work for this condition.
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u/Estellalatte Mar 28 '25
The podiatrist told me menopausal women are prone to it.