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The purpose of this case report was to examine barefoot training and foot intrinsic musculature strengthening within a comprehensive PT plan of care for type II PTTD. Posterior Tibialis Tendon Dysfunction (PTTD) affects ~10% of the population, where Stage I: medial arch pain, possible pain with heel elevation, and mild ankle/foot swelling, Stage II: Stage I + flexible flatfoot deformity, Stage III: Stage I + fixed flatfoot deformity, Stage IV: tibiotalar degeneration stemming from valgus tilt of talus in ankle mortise. Barefoot training increased plantar surface proprioception, increased activation of foot intrinsic musculature, decreased running injuries. Foot Intrinsic Musculature Strengthening with Short-foot Exercise showed highest EMG for intrinsic musculature improved balance scores in patients with chronic ankle instability, decreased navicular drop in patients with pes planus and hyper-pronation, and increased support of the medial longitudinal arch. Three randomized controlled trials showed positive outcomes with comprehensive plan of care. Studies have yet to include barefoot training or intrinsic foot musculature strengthening in conservative management of PTTD.
Heindel, Matthew and Buchanan, Kirsten, "Barefoot Rehabilitation Of Type II Posterior Tibialis Tendon Dysfunction In A Veteran: A Case Report" (2018). Case Report Posters. Poster 149.