FAQ

Can PTTD Affect Both Feet?

Yes, PTTD can affect both feet — but it's not the most common presentation. Here's what you need to know about bilateral PTTD.

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Can PTTD Affect Both Feet?

Yes, PTTD can affect both feet — but it’s not the most common presentation. Here’s what you need to know about bilateral PTTD.

The Numbers

About 30% of PTTD cases are bilateral, meaning the condition affects both feet. The majority — roughly 70% — start in just one foot.

If you currently have PTTD in one foot, there’s a significant chance the other foot could develop it later, especially if you have underlying risk factors.

Why Does Bilateral PTTD Happen?

Bilateral cases tend to occur more often when there’s a systemic condition or ongoing risk factor involved. These include:

  • Rheumatoid arthritis — inflammatory conditions can affect tendons in both feet
  • Diabetes — affects connective tissue and circulation
  • Genetic connective tissue disorders — like Ehlers-Danlos syndrome
  • Obesity — increases strain on both posterior tibial tendons
  • Previous foot trauma to both feet

What to Watch For

If you have PTTD in one foot, don’t ignore the other. Here’s what to keep in mind:

  • Early signs in the second foot can be subtle — mild arch fatigue, slight ankle swelling, or minor pain after activity
  • The “too many toes” sign can appear in either foot
  • Regular self-checks help catch issues early

The Bottom Line

Most people with PTTD have it in only one foot. But if you have one affected foot, pay attention to the other. If you notice new symptoms — pain, swelling, or changes in your arch — mention it to your doctor at your next appointment.

This information is for educational purposes only. Consult your healthcare provider for personalized medical advice.