Science Behind the Use of Orthotic Devices to Manage Posterior Tibial Tendon Dysfunction

The clinical classification of posterior tibial tendon dysfunction has historically included 4 stages. Trials of conservative management have been recommended before surgical options are explored, and various orthotic devices have been proposed in the literature. The purpose of this article is to review the current evidence for orthotic device use in the conservative management of posterior tibial tendon dysfunction and identify areas where additional research is needed. Focus will be given to both clinical outcomes and current biomechanical data from investigating the use of various orthotic devices. From this summary, clinical recommendations will be made for the use of the devices available. Finally, goals for future device designs will be proposed.