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Taping Techniques for Posterior Tibial Tendon Dysfunction

by Jaydee Vykoukal, PT, DPT April 13, 2022 0 Comments

Woman taping her foot

When dealing with Posterior Tibial Tendon Dysfunction, taping techniques applied to the foot, ankle, and heel can aid in pain relief and injury prevention. PTTD is a common injury in runners and athletes, particularly with high-impact sports. It can be caused by overuse, training on hard surfaces, worn-out shoes, or simply because you have flat feet. Tape can help the foot properly absorb impact and promote optimal biomechanics. 

This article will discuss how to use kinesiology tape for PTTD along with alternative taping and bracing options.

Posterior Tibial Tendon Dysfunction Taping Techniques

There are a variety of techniques recommended for PTTD. You may have to experiment with the different options to see which one(s) provides you the most pain relief and support. Additionally, you can consult a physical therapist or podiatrist for specific recommendations for kinesiology taping. Below are instructions for the three primary techniques that can be used on their own or combined. 

Tips Before Getting Started

Taping for Arch Support

Placing tape directly across the arch can help provide proprioception (being aware of how your foot is moving) and gentle support to prevent collapsing into a flatfoot deformity. This simple technique can help reduce strain on the posterior tibialis as well and promote better biomechanics with weight-bearing activities.

  1. Cut a small piece of tape that is long enough to go across the bottom of the foot horizontally (perpendicular to the direction of your toes)
  2. Clean the area you will be taping with soap and water or alcohol
  3. Use scissors to round the edges of the tape to reduce the chance of early peeling
  4. Anchor one edge of the tape (approximately 2 inches with no stretch) to the outside edge of the foot (at the midfoot/base of the 5th metatarsal) so that it will cross the bottom of the arch
  5. Apply a small amount of stretch in the tape as you place the tape on the bottom of the foot and arch
  6. Anchor the other end of the tape to top of the inside of the foot (once again- the midfoot at the base of the big toe)
  7. Rub the tape to promote adhesion
  8. For bigger feet, consider adding a second layer that is staggered to overlap approximately 50% with the first line of tape
  9. Leave on for up to 3 days as long as your skin can tolerate it, then remove carefully and reapply as needed
  10. Combine with any of the other techniques below to maximize your ankle and foot support

Taping for Medial Ankle Support

Placing tape along the inside of the ankle can provide direct relief to the posterior tibialis muscle. It can also provide proprioception and biomechanical feedback with activities like walking and running to gradually reduce strain on the injured tissues. It can seamlessly be added to the arch technique we just reviewed above.

  1. Cut a long piece of tape that will wrap around the bottom of the heel and up along the inside ankle and calf
  2. Clean the area you will be taping with soap and water or alcohol
  3. Use scissors to round the edges of the tape to reduce peeling
  4. Anchor one edge of the tape (approximately 2 inches with no stretch) to the outside edge of the heel (under the outside ankle bone) so that it can wrap under the heel and across the inside ankle
  5. Apply a gentle stretch in the tape as you pull it under the heel
  6. Continue pulling as you wrap the tape up toward the ankle and across the inner ankle bone, known as the medial malleolus
  7. Then, keep the tape parallel with the shin bone as you finish applying the tape along the inner lower leg
  8. Place the anchor at around one half to two-thirds of your shin bone
  9. Rub the tape to sufficiently promote adhesion
  10. For bigger feet and ankles, consider adding a second layer that is staggered to overlap approximately 50% with the first piece of tape
  11. Leave the tape on for up to 3 days as long as your skin can tolerate it, then remove carefully and reapply as needed
  12. Combine with any of the other techniques in this article to maximize your ankle and foot support

Taping for Heel Support

Taping the heel can provide gentle support and prevent excessive ankle range of motion with daily activities that can aggravate your PTTD injury. It’s a great addition to the other taping techniques reviewed above if needed. 

  1. Cut a medium-sized piece of tape that will wrap across the back of the heel and Achilles tendon
  2. Clean the area you will be taping with soap and water or alcohol
  3. Use scissors to round the edges of the tape to reduce the chance of peeling
  4. Anchor one edge of the tape (approximately 2 inches with no stretch) to the outside edge of the foot at the base of the little toe so that it will wrap back behind and across the Achilles tendon
  5. Gently pull as you lay the tape along the entire outer edge of the foot and then across the back of the ankle
  6. Continue pulling as you now go along the inside edge of the foot until your reach the base of the big toe
  7. Anchor the tape along the big toe
  8. Take care to keep the tape below the ankle bones to prevent irritation and provide adequate heel support
  9. Rub the tape again to promote adhesion
  10. For bigger feet and ankles, consider adding a second layer that is staggered to overlap approximately 50% with the first tape
  11. Leave the tape on for up to 3 days as long as your skin can tolerate it, then remove carefully and reapply as needed

How Kinesiology Tape Works

Kinesiology tape is primarily used for better foot and ankle feedback and assisting in biomechanically correct movements. The elastic properties in the tape are what allow you to be keenly aware of how you’re moving as it tugs at your skin. Additionally, the tape gently lifts the skin to promote blood flow and pain relief. Depending on how it is applied, it can help relax a muscle or give it a gentle push to work better.

More on How Kinesiology Tape Works

Kinesiology tape is a great tool to utilize with other treatment options, such as stretching, strengthening exercises, anti-inflammatory medication (NSAIDS), and physical therapy, to maximize your outcomes after an injury.

Treatments for PTTD

Other indications for Kinesio tape include plantar fasciitis, peroneal tendonitis, bunions, general foot or ankle pain, Achilles tendonitis, and more.  

Other Options

Other options for PTTD include athletic tape or braces that wrap around the ankle and/or foot and provide support through compression. 

Athletic Tape

Athletic tape is a great option for short-term foot and ankle stability, particularly preventing ligament damage from rolling of the ankle (inversion ankle sprains). It is made out of cotton fibers with no stretch and is traditionally used during high-impact sports like football and basketball for support. Athletic tape is less comfortable and can only be worn for a few hours. An athletic trainer or physical therapist can show you how to use this type of tape if you need it.

Bracing

Bracing can be a long-term solution for foot and ankle instability. When your foot and ankle injury has led to permanent instability or damage, or you want to prevent reinjury, you may need a brace for the lower leg.

There are a variety of different braces that can help with PTTD, but you’ll need to make a selection based on your specific deficits. This might include a neoprene ankle brace or a stiffer brace to prevent excessive foot and ankle motion. Talk to your orthopedic doctor or therapist if you’re not sure which brace is right for you.

Compare Different Types of Braces Here

Give Yourself the Upper Hand

While kinesiology tape on its own probably won’t heal your PTTD, using it in conjunction with other treatment options can help expedite your results and potentially allow you to get back to feeling your best sooner. Kinesiology tape is a low-cost tool in your recovery toolbox that can make a big difference in your mechanics and help you reach your goal of becoming pain-free. It can also help you determine if support for the arch of the foot with a generic orthotic, a custom orthotic, or a brace is worth investing in. It’s definitely worth a try!

References:

http://www.drblakeshealingsole.com/2011/06/taping-for-posterior-tibial-tendon.html

https://orthoinfo.aaos.org/en/diseases--conditions/posterior-tibial-tendon-dysfunction/

https://my.clevelandclinic.org/health/diseases/22057-posterior-tibial-tendon-dysfunction#prevention

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT



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