Best Shoes for PTTD: Footwear Recommendations That Actually Help

If you have posterior tibial tendon dysfunction, the shoes you wear matter—a lot. The right footwear can reduce pain, support your arch, and slow the progression of the condition. The wrong shoes can make everything worse. Here’s what you need to know about choosing footwear that actually helps.

Why Footwear Matters with PTTD

Your posterior tibial tendon exists to support your arch. When that tendon is damaged or weakened, your arch can collapse further with every step. Supportive shoes essentially do some of the work your compromised tendon can’t do alone.

This is why footwear isn’t just about comfort—it’s part of your treatment plan. The right shoes reduce stress on your posterior tibial tendon, help maintain proper foot alignment, and can even reduce pain when you’re standing or walking.

Features to Look For

Not all “supportive” shoes are created equal. Here’s what matters:

Firm Heel Counter

The heel counter is the back part of the shoe that cups your heel. It should be firm and not collapse when you press on it. This keeps your heel stable and prevents excessive inward rolling.

Arch Support

Look for shoes with built-in arch support—either through the insole or the shoe’s design. This helps distribute pressure evenly across your foot.

Wide Base

A wider shoe base provides more stability. Avoid narrow, pointy shoes that compress your foot.

Rigid Sole

The sole shouldn’t bend easily in the middle. A stiffer sole helps control excessive pronation.

Removable Insole

This lets you swap in custom orthotics if needed.

Good Traction

Prevents slipping and falling, which is especially important if you have balance issues from PTTD.

Types of Supportive Shoes

Motion Control Shoes

These are the most structured running shoes, designed for people with significant overpronation. They have firm midsoles and extended arch support. Best for: severe flat feet, high body weight, significant PTTD.

Stability Shoes

Moderate support shoes that combine cushioning with support elements. Good for: mild to moderate overpronation, most people with PTTD.

Walking Shoes

Walking shoes often have excellent arch support and firm heels. They’re a good everyday option. Look for walking shoes specifically designed for arch support.

Orthopedic Shoes

For severe cases, orthopedic or “medical grade” shoes provide maximum support. These are often covered by insurance with a prescription.

Specific Brand Recommendations

Based on support and durability:

Running/Walking Shoes

  • Brooks Adrenaline GTS: Excellent stability, good arch support
  • ASICS Gel-Kayano: Motion control with comfortable cushioning
  • New Balance 928: Walking shoe with excellent support
  • Saucony Echelon: Good stability with room for orthotics
  • Hoka Bondi: Maximum cushioning with moderate support

Everyday Shoes

  • Vionic: Orthotic-friendly sandals and casual shoes
  • Dansko: Clogs and casual shoes with good arch support
  • Birkenstock: Sandals with contoured footbeds (good for summer)
  • Keen: Casual and hiking shoes with good stability

Athletic Shoes for Activities

  • Look for the features above rather than specific brands
  • Replace athletic shoes every 300-500 miles

What to Avoid

Certain shoes make PTTD worse:

  • Flats: No arch support, maximum stress on the tendon
  • Flip-flops: Zero support, your toes work overtime to keep them on
  • Worn-out shoes: Lost their support, actually worse than going barefoot
  • Minimalist shoes: Designed for natural foot movement, which stressed PTTD
  • High heels: Push pressure to the forefoot, alter gait
  • Narrow shoes: Compress the foot, force the arch to collapse

Custom Orthotics + Good Shoes

For many people with PTTD, custom orthotics combined with supportive shoes provide the best results. The orthotic corrects your specific foot mechanics, while the shoe provides a stable platform.

If you get custom orthotics, bring them when shoe shopping—make sure they fit inside the shoes you’re considering.

Replacing Your Shoes

Shoes lose their support over time:

  • Athletic shoes: Every 300-500 miles or when the tread wears out
  • Everyday shoes: Every 6-12 months depending on wear
  • Look for signs: If the heel is worn down on one side, the sole is curved, or the insole is compressed, it’s time for new shoes

The Bottom Line

Don’t underestimate the power of good shoes. While they won’t cure PTTD on their own, they’re a foundational part of treatment. Invest in quality supportive shoes, replace them regularly, and your feet will thank you.

Sources

  • American Academy of Orthopaedic Surgeons (AAOS) - Posterior Tibial Tendon Dysfunction
  • American Podiatric Medical Association - Footwear guidelines