Flat foot is quite a common problem of the foot, but most of the time merely having a lower arch or flatter foot is not always a problem. What is a concern is if it is progressive and becomes painful, then it is referred to as posterior tibial tendon dysfunction or adult acquired flatfoot. In these cases the arch of the foot becomes progressively flatter and the rearfoot rolls inwards. This is usually accompanied with pain in the arch of the foot and in the ankle region. Those with this also find walking is a lot is a lot and walking uses a lot of energy leading to a lot of tiredness.The reason for posterior tibial tendon dysfunction is not fully understood, however it is a problem in which the posterior tibial tendon and muscle are unable to just do the job that it is designed for.
The key role of the posterior tibial tendon is to support the arch of the foot and prevent the heel rolling inwards. For some reason the muscle and tendon complex are unable to just do that job any more, resulting in the progressive nature of this condition.The management of posterior tibial tendon dysfunction is somewhat urgent and needs to be addressed as soon as it possibly can. The reason being the disorder is progressive and it will reach a point where conventional methods don't work and surgery is the only option. As you move the surgical outcomes are typically acceptable, they do consist of the fusion of some joints to stop the disorder getting worse, that comes with some long term restrictions on gait and function, so is best avoided. To prevent the surgical option, treatments should be started early. This will likely consist of foot supports that are very supportive and position the foot back in the correct position. Exercises are also recommended, but should not be used instead of foot supports, as they are essential to stop this problem from getting worse.