Is there evidence in the literature to support the use of functional orthotic devices?
The only supporting evidence relative to orthotic treatment of posterior tibial tendon dysfunction (PTTD) are studies of ankle foot orthoses (AFOs), according to Doug Richie Jr., DPM. Regarding PTTD, he says the evidence is “quite impressive” as it reveals that over 50 percent of patients can obtain satisfactory relief of pain and can avoid surgery. These studies cited by Dr. Richie primarily utilize solid AFOs with leather gauntlet restraint closures. Regarding functional foot orthoses, Dr. Richie says reports in the literature are anecdotal when it comes to rates of success and outcomes of treatment. He notes that overall, the success and specific prescription criteria for orthotic therapy for PTTD “remain open for debate.” Orthopedic literature usually recommends using a University of California Biomechanics Laboratory (UCBL)-type device as the typical orthotic intervention before surgery, says Dr. Richie. He adds that he is not aware of any studies of patients with PTTD using a pod
