Flatfoot is a fairly common condition that affects the foot. However, most of the time merely having a flatter foot is not necessarily an issue or causes problems. What is a problem is if it is progressive and becomes painful, then it’s referred to as posterior tibial tendon dysfunction or adult acquired flatfoot. In such cases the arch of the foot becomes steadily flatter and the rearfoot rolls inwards at the ankle. This is usually accompanied by pain in the arch of the foot and in the rearfoot region. Those with this progressive problem also find walking is a lot more difficult and walking uses a lot of effort leading to lots of tiredness.
The explanation for the cause of posterior tibial tendon dysfunction is not fully understood, however, it is a problem in which the posterior tibial tendon and muscle can not just do the task that it is designed for. The primary role of the posterior tibial tendon
is to hold up the arch of the foot and stop the heel rolling inwards. For some reason the muscle and tendon unit can not just do that effectively anymore, bringing about the progressive collapse of the arch that is the hallmark of this problem.
The treatment of posterior tibial tendon dysfunction
is somewhat important and needs to be addressed as soon as it possibly can. This is due to the condition being progressive and it will reach a point where conventional measures fail to work and surgery is the only alternative. As the surgical outcomes are in general satisfactory, they do involve the fusion of some joints to prevent the condition getting worse. That surgery comes with some long term limitations on gait as well as function, so is best avoided. In order to avoid the surgical option, treatments should be started early. This will involve foot orthotics that are really supportive and angle the foot back in the right direction. Exercises are also recommended, but should never be used rather than foot supports, as they are crucial to stop this problem from progressing.