PTTD and work: employment with posterior tibial tendon dysfunction

One of the most practical concerns people have after a PTTD diagnosis is how it will affect their job. Will they be able to keep working? Do they need to switch careers? What accommodations are available? These are real questions with real answers—and the news is generally better than you might expect.

How different jobs affect PTTD

Not all work situations affect PTTD equally. Understanding where your job falls helps you plan.

Standing and walking jobs

Jobs that require long periods of standing or walking—teacher, nurse, retail worker, chef, warehouse employee—put the most stress on your posterior tibial tendon. The constant load on your arch and ankle accelerates wear on an already compromised tendon.

If you have a standing job, expect some challenges. You’re not disabled from working, but you’ll likely need to make modifications. More on that below.

Sedentary office jobs

Office work is generally more manageable with PTTD. Sitting reduces load on your tendon, though prolonged sitting has its own issues (stiffness, reduced circulation). Most people with PTTD can continue office work without major problems, especially with proper accommodations.

Physical labor

Construction, landscaping, and other heavy physical work presents the biggest challenges. These jobs put extreme stress on your feet and ankles. You may need to discuss modified duties with your employer or explore other options.

Remote and flexible work

Jobs that let you control your schedule and work environment offer the most flexibility. If you can work from home, you have more control over taking breaks, elevating your feet, and managing symptoms.

Workplace accommodations that help

The Americans with Disabilities Act (or similar laws in other countries) requires employers to provide reasonable accommodations for qualifying conditions. PTTD can qualify, especially if it limits your ability to stand, walk, or perform certain tasks.

For standing jobs

Request accommodations such as:

  • A sit-stand desk or stool to alternate between sitting and standing
  • Anti-fatigue mats for areas where you must stand
  • Scheduled breaks every 30-60 minutes to sit and rest
  • Permission to shift weight and move around
  • Supportive footwear allowance
  • A footrest to elevate one foot at a time while sitting

For office jobs

Even office workers benefit from:

  • An ergonomic footrest to reduce strain on your arch
  • A chair with proper lumbar and leg support
  • Permission to take brief walks every hour
  • A height-adjustable desk
  • Ice packs or cold therapy available at your desk
  • A place to put your feet up during breaks

Talking to your employer

Be honest but professional. Explain that you have a medical condition affecting your foot/ankle that requires some modifications. You don’t need to share detailed medical information—just the functional limitations and what helps.

Most employers would rather make reasonable accommodations than lose a good employee. Frame the conversation as finding solutions that let you continue doing your job effectively.

When PTTD might qualify as a disability

PTTD becomes a disability when it substantially limits major life activities. This varies by case, but you may qualify if:

  • You cannot stand or walk for extended periods without significant pain
  • You require a cane, brace, or other assistive device
  • Your condition affects your balance or increases fall risk
  • You need accommodations that go beyond minor adjustments

If you believe your PTTD qualifies, consult with your doctor about documentation. Social Security Disability Insurance (SSDI) or similar programs have specific criteria for musculoskeletal conditions.

Worker’s compensation considerations

If your PTTD developed or worsened due to job conditions, you may have a worker’s compensation claim. This is more common in jobs with repetitive stress or prolonged standing. Each case depends on the specific circumstances and your jurisdiction’s laws.

Report any work-related injury or condition to your employer promptly. Document your symptoms and medical care. Consult with a workers’ comp attorney if needed.

Returning to work after surgery

If you require surgery, planning for your return is essential.

After flatfoot reconstruction

Most people return to desk work within 2-3 months. Jobs requiring standing or walking may take 4-6 months. You may start with limited hours and build up gradually.

After tendon repair

Recovery depends on the specific procedure. Your surgeon gives you guidelines. Plan for gradually increasing your workload rather than jumping back to full duties.

Tips for a smooth return

  • Start with partial days or modified duties
  • Continue any physical therapy exercises
  • Use ice and put your feet up during breaks
  • Communicate with your employer about your limitations
  • Don’t rush—re-injury delays recovery

The bottom line

Most people with PTTD continue working in some capacity. The key is matching your job demands with your physical capabilities, making accommodations when needed, and communicating openly with your employer. Whether you have a standing job, office work, or physical labor, there are solutions that let you maintain employment while managing your condition.

If your job is causing significant problems despite modifications, it may be worth exploring whether a transition to less demanding work makes sense—either temporarily during recovery or long-term. Your health comes first.

Sources

  • Americans with Disabilities Act: Reasonable accommodations
  • Social Security Administration: Disability evaluation for musculoskeletal conditions
  • Journal of Foot and Ankle Surgery: PTTD and occupational impact